Endoscopic vaporization of benign prostatic hyperplasia using a contact 980 nm diode laser under antithrombotic therapy: A prospective survey

Abstract

Introduction: To prospectively clarify whether endoscopic contact laser vaporization of the prostate (CVP) can be safely performed even in patients undergoing antithrombotic therapy. Methods: Fifty-five patients treated with CVP were enrolled. Patients were assigned to: (i) the antithrombotic therapy group (n = 21, 38%); or (ii) control group without antithrombotic therapy (n = 34, 62%). All patients in the antithrombotic therapy group continued all antithrombotic agents during the perioperative period and thereafter. Results: No difference was noted in patient background between the two groups. In primary endpoints, decreases in the postoperative hemoglobin level were remarkable in the antithrombotic therapy group, while no serious effects were noted in either group. The control and antithrombotic therapy groups did not show a significant difference in the occurrence of catheter obstruction due to blood clots or serious hematuria following catheter removal. During followup, transurethral coagulation for hemostasis was needed only in the antithrombotic therapy group, with a frequency of transurethral coagulation of up to 14%. In secondary endpoints, no difference in the occurrence of perioperative or late-onset complications after surgery was noted between the two groups. Finally, no difference was noted in improvements in the International Prostate Symptom Score (IPSS), IPSS quality of life score, overactive bladder symptom score, maximum flow rate, or post-voiding residual urine volume between the two groups throughout the follow-up period. Conclusions: CVP can be performed safely and effectively in patients undergoing continuous antithrombotic therapy. However, the possibility of

Evaluation of learning curves for contact laser vaporization of the prostate using the 980 nm diode laser for benign prostatic hyperplasia

“…Sanjo et al. reported that CVP can be performed safely and effectively in patients undergoing continuous antithrombotic therapy 12 . According to these studies, the results for operative time and complications were not significantly different from our results.…”

“…Therefore, in this study, we used three items as trifecta (operative time, operative efficacy, and complications). Previous studies investigated operative efficacy (calculated as the prostate volume divided by operative time) and initial experience reports were 0.61-1.0 cc/min, [10][11][12] with no difference in our study. In addition, previous clinical studies on TURP reported that operative efficacy (preoperative prostate volume divided by operative time) was approximately 0.85-1.0 cc/min and the operative resection efficacy (resection weight divided by operative time) was approximately 0.54-0.67 g/min.…”

Outcome of diode laser vaporization for high risk patients with ‎benign prostatic hyperplasia.

“…20 Previous studies have documented a significant prevalence of dysuria and burning micturition. 21 The prevalence rates of dysuria and burning micturition in this study were 29% and 46%, respectively. In addition, a limited number of studies have documented elevated re-operation rates ranging from 8% to 33% and a persistent prevalence of stress urine incontinence at 9.1%, while we have found 11% stress incontinence.…”

Concomitant Prostate Needle Biopsy and Laser Vaporization of the Prostate Could Be a Risk of Postoperative Hemoglobin Decline, a Retrospective Study

“…CVP and other endoscopic laser vaporization procedures can be safely performed even in patients under antithrombotic therapy because of reduced bleeding compared with traditional transurethral surgery. 2,5,6 As patients undergoing surgery for BPH are aging, the number of patients receiving antithrombotic therapy has increased, and laser vaporization techniques have gained popularity as a treatment for BPH. 16,17 Among patients for whom laser vaporization of the prostate is considered, a certain number of patients have slightly elevated PSA levels but a low likelihood of prostate cancer.…”

“…[2][3][4] Laser vaporization of the prostate is associated with reduced bleeding compared with traditional transurethral surgery and is considered safe, even for patients under antithrombotic therapy. 2,5,6 Prostate cancer is the second most commonly diagnosed cancer in men. 7 Prostate-specific antigen (PSA) screening test is recommended for early detection of prostate cancer, particularly in elderly men.…”