Nd:YAG laser ablation plus transurethral resection for large prostates in high-risk patients

Gürdal, Mesut; Tekın, Ali; Yücebaş, Ergin; Şengör, Feridun

doi:10.1016/s0090-4295(03)00659-9

Cited by 15 publications

(6 citation statements)

References 26 publications

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“…A recent trial described visual Nd: YAG laser application followed by TURP in patients at high risk who also presented with an ASA score of 3 or more. 11 In general their results concerning safety and efficacy were comparable to those presented in our study. Nevertheless, it must be mentioned that only 28 patients underwent this protracted 2-stage procedure.…”

Section: Resultssupporting

confidence: 87%

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

et al. 2005

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Section: Resultssupporting

confidence: 87%

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

et al. 2005

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“…The other disadvantage of PVP is that it cannot provide tissue for diagnostic examination to exclude patients with prostate cancer. Therefore, using DRE, TRUS and PSA measurements, the patients were evaluated before the PVP procedure [17].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia

Fu¹,

Hong²,

Wang³

et al. 2006

Asian J Andrology

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Aim: To explore the feasibility and safety of greenlight photoselective vaporization of the prostate (PVP) on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH) and to evaluate their clinical and voiding outcome. Methods: A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score (IPSS), quality of life score (QoL), uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results: All patients got through the perioperative period safely. The chief advantages of PVP were: short operative time (25.6 ± 7.6 min), little bleeding loss (56.8 ± 14.3 mL) and short indwelling catheterization (1.6 ± 0.8 d). The IPSS and QoL decreased from (29.6 ± 5.4) and (5.4 ± 0.6) to (9.5 ± 2.6) and (1.3 ± 0.6), respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data (P < 0.05). No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion: PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of Keywords: benign prostatic hyperplasia; photoselective vaporization of the prostate; high-risk; laser surgery; prostate . Clinical Experience .

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“…Among the surgical techniques, the gold standard treatment, TURP, has been applied with significant success rates for years and it significantly improves urinary symptoms and urinary flow. However, it is well known that, despite its common acceptance and widespread application, complications can be seen in up to 20% of cases following a successful intervention (10,(19)(20)(21). Currently, there are a number of minimally invasive procedures that may be safe and effective alternatives to TURP.…”

Section: Commentsmentioning

confidence: 99%

Photoselective vaporization of the prostate in men with a history of chronic oral anti-coagulation

et al. 2010

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Purpose: A considerable percentage of patients with benign prostatic hyperplasia (BPH) also have additional cardiac pathologies, which often require anticoagulant therapy. The aim of this study was to evaluate the efficacy and safety of photoselective vaporization of the prostate (PVP) for BPH in cardiac patients receiving anticoagulant therapy. Materials and Methods: A total of 67 patients suffering from BPH and high risk cardiac pathologies were operated on using laser prostatectomy. All patients had cardiac pathologies with bleeding disorders requiring anticoagulant use, and underwent standard urologic evaluation for BPH. Patients were treated with laser prostatectomy for relief of the obstruction using the KTP/532 laser energy at 80 W. Results: The mean patient age was 71.4 years (range 55-80). Mean prostate volume on transrectal ultrasonography was 73.2 mL (range 44-120). Operation time ranged from 40 to 90 min, with an average value of 55 min. The average hospital stay was 48 hours (range 12-72) and the Foley catheters were removed within 48 hours, with a mean catheterization time of 34.2 ± 5.9 hours (0-48). No patient required an additional procedure due to severe bleeding necessitating intervention during the early postoperative phase. Mean International symptoms scoring system (IPSS) values and post voiding residual volume decreased and peak urinary flow rate increased (p < 0.001). Our results showed that the mean prostate volume had decreased by 53% at 6 months. Conclusions: High-power photo selective laser vaporization prostatectomy is a feasible, safe, and effective alternative for the minimal invasive management of BPH, particularly in cardiac patients receiving anticoagulant therapy.

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Nd:YAG laser ablation plus transurethral resection for large prostates in high-risk patients

Cited by 15 publications

References 26 publications

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

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

Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia

Photoselective vaporization of the prostate in men with a history of chronic oral anti-coagulation

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