High Power (80 W) Potassium-Titanyl-Phosphate Laser Vaporization of the Prostate in 66 High Risk Patients

Reich, Oliver; Bachmann, Alexander; Siebels, M.; Hofstetter, A.; Stief, Christian G.; Sulser, Tullio

doi:10.1097/01.ju.0000146631.14200.d4

Cited by 233 publications

(125 citation statements)

References 19 publications

(13 reference statements)

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“…Importantly, as in other studies [10,16], there was no TUR syndrome. However, there was severe macrohaematuria after surgery, with one patient requiring a blood transfusion and cystoscopic clot removal.…”

Section: Discussionsupporting

confidence: 60%

“…Recent studies showed reduced blood loss and avoidance of TUR syndrome even in high-risk patients [10][11][12]. Thus, the objective of the present study was to use the Greenlight system for treating of BPH in prostates of ≥ 80 mL, and to investigate the safety and outcome of this procedure, comparing it with results from Greenlight therapy for smaller prostates of < 80 mL.…”

Section: Introductionmentioning

confidence: 99%

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Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

et al. 2008

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OBJECTIVETo compare the safety and outcome of potassium‐titanyl‐phosphate (KTP) GreenlightTM (Laserscope, AMS, Minnetonka, MN, USA) vaporization for treating benign prostatic hyperplasia (BPH) in prostates of ≥80 vs <80 mL.PATIENTS AND METHODSIn all, 204 consecutive patients were enrolled into this prospective study; 31 were excluded from analysis for various reasons, thus 173 (median age 66.8 years; 39 with prostates of ≥80 mL) were evaluated for maximum urinary flow rate (Qmax), postvoid residual urine (PVR), the International Prostate Symptom Score (IPSS), and quality‐of‐life (QoL) score. The median follow‐up was 11.7 months. Of the 173 men, 26.6% were anaesthesiological high‐risk patients and 32.4% took anticoagulants.RESULTSThe Qmax improved in prostates of ≥80 mL from 6.9 mL/s before to 15.3 mL/s immediately after catheter removal, and 23.4 mL/s after 3 months (P < 0.001). The improvement was similar to that in smaller prostates. There were equally effective changes in PVR (P < 0.001). The IPSS decreased from 19.0 before to 7.0, 4.0 and 5.5 at 3, 6 and 12 months after surgery (P < 0.001). Changes did not differ from those in smaller glands. The results were similar for QoL (P < 0.001). During surgery there was no major bleeding and no transurethral resection syndrome. There was acute urinary retention after catheter removal in 10.4% of men; 4.6% developed urinary tract infections, whereas the rate was higher in men with larger prostates (10.3%). The re‐operation rate was higher in men with larger prostates, at 23.1% vs 10.4% (P = 0.09).CONCLUSIONKTP laser vaporization is a safe and effective procedure for surgically treating BPH. The functional outcome in larger prostates is similar to that in smaller glands, but there was a serious trend to a higher re‐operation rate in men with larger prostates.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

et al. 2008

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“…In studies where patients undergoing TURP or KTP laser prostatectomy were directly compared, the short-term efficacy was equivalent at 6 and 12 months, but with a significantly shorter catheterization and inpatient stays in the laser group [3,4]. It also provides a virtually bloodless operation, and has been used safely and effectively in highrisk candidates on anticoagulation therapy [5,6], with no haemorrhagic complications. There are no reported requirements for blood transfusion.…”

Section: Introductionmentioning

confidence: 99%

Does laser ablation prostatectomy lead to oncological compromise?

et al. 2009

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records, histopathology databases and The British Association of Urological Surgeons Cancer Registry. We recorded the total number of prostate cancers diagnosed per year, number of TURPs performed, Gleason scores and patients outcomes. Of newly diagnosed patients, 82% were allocated to active surveillance, whilst 18% were started on hormone therapy, with no prostate cancer-related deaths over a mean ( SEM , range) follow-up of 49.7 (2.4, 11-81) months. RESULTS TURP CONCLUSIONSTURP mainly samples transitional-zone tissue where tumours are relatively uncommon, and have a good prognosis. Our series of incidental TURP-detected cancers showed an incidence in keeping with published data, and favourable histological and clinical outcomes. We suggest the lack of tissue should not discourage the use of laser prostatectomy surgery.

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“…Qmax values had increased by 250% at 3 months, 242% at 6 months, 255% at 12 months and 278% at 24 months postoperatively. In another study, decreases in IPSS values at 1, 3, 6 and 12 months postoperatively were 42%, 61%, 66% and 68%, respectively, and Qmax values increased by 176%, 182%, 187% and 222%, respectively [12]. Results from Hai [13] established the long-term durability of high-power KTP laser vaporization, demonstrating that it can be used for glands of all sizes, in high-risk and anticoagulated patients, and with minimal morbidity and sustained clinical outcomes.…”

Section: Discussionmentioning

confidence: 87%

Treatment satisfaction after 1 year high-power potassium-titanyl-phosphate photoselective vaporization of the prostate

Cho

Kim

et al. 2010

Asian J Androl

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To investigate the factors that influence treatment satisfaction after high-power potassium-titanyl-phosphate (KTP) laser vaporization of the prostate, we compared the characteristics between patients who were satisfied and those who were not satisfied. In all, 97 patients aged between 53-82 years (median age 67 years) underwent high-power KTP laser vaporization of the prostate for lower urinary tract symptoms due to benign prostatic hyperplasia. At 12 months postoperatively, 60 patients were satisfied with the treatment, whereas 37 were dissatisfied. Although there were no differences in International Prostate Symptom Score (IPSS) values at baseline, the satisfied group scored better in total IPSS at 1, 3, 6, and 12 months postoperatively (P < 0.05). At baseline, the maximum flow rate (Qmax) was lower in the dissatisfied group and remained low throughout the follow-up period, with the exception of 1 month postoperatively (P < 0.05), compared with the satisfied group. There were no differences in other objective data between the two groups, including post-void residual and the number of voids based on the frequency-volume charts. In a multivariate model, a higher bladder contractility index was associated with a greater likelihood of treatment satisfaction 12 months after high-power KTP laser vaporization (odds ratio 1.024, 95% confidence interval 1.001-1.048, P < 0.05). Patients who were not satisfied following the surgery had a smaller improvement in subjective symptoms and Qmax. In addition, our findings suggest that the relative risk of treatment dissatisfaction following high-power KTP laser vaporization was increased in patients with weak detrusor contractility.

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High Power (80 W) Potassium-Titanyl-Phosphate Laser Vaporization of the Prostate in 66 High Risk Patients

Abstract: Our initial experience indicates that 80 W KTP laser vaporization is a virtually bloodless and, hence, safe but effective treatment option in seriously ill patients or those on oral anticoagulants.

Cited by 233 publications

References 19 publications

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

Does laser ablation prostatectomy lead to oncological compromise?

Treatment satisfaction after 1 year high-power potassium-titanyl-phosphate photoselective vaporization of the prostate

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