Photoselective Vaporization of the Prostate: Initial Experience with a New 80 W KTP Laser for the Treatment of Benign Prostatic Hyperplasia

Hai, Mahmood A.; Malek, Reza S.

doi:10.1089/08927790360587414

Cited by 163 publications

(73 citation statements)

References 10 publications

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“…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%

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: 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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“…Although effective, the technique can be associated with significant complications, including TUR syndrome and bleeding [3][4][5][6]. Newer technologies such as PVP offer safer and equally effective alternatives to relieve symptomatic bladder outlet obstruction [7][8][9][10][11][12][13][14][15]. Few studies however have directly examined the clinical differences between 80 W vs. 120 W PVP [17].…”

Section: Discussionmentioning

confidence: 99%

“…This technique has been shown to result in comparatively fewer complications, e.g. reduced incidence of TUR syndrome as well as bleeding [7][8][9][10][11][12][13][14][15], Improvements to the Greenlight ™ laser system have been made over time, particularly with the introduction of the 120 W HPS system in 2006. Few however have compared the clinical performance of the newer systems with their predecessors.…”

Section: Introductionmentioning

confidence: 99%

Comparison of 80 W versus 120 W 532 nm Laser Prostatectomy for BPH

Lee¹

2013

OJU

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Purpose: Improvements to photoselective vaporization of the prostate (PVP) have been made over time, particularly with the introduction of higher power systems. Few studies however have compared the performance of these systems to their predecessors. Baseline parameters were similar between the two groups except for greater median age (72.8 vs. 69.2 years, p = 0.01) and lower median PSA (2.0 vs. 3.3, p = 0.01) in the 80 W group. Median laser time was longer in the 80W group (85 vs. 51 minutes, p < 0.001) with a higher median energy utilized (253 vs. 210 kJ, p = 0.001). Final IPSS, Qmax, PVR, and PSA were equivalent between the two groups. Conclusions: In our series, PVP was safe and effective. Durable and similar improvements in symptoms and objective parameters were achieved in patients with both 80 W and 120 W laser systems. PVP with the 120 W system, however, provided faster and more efficient vaporization compared to the 80 W system.

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“…The first use of an 80-W KTP laser on humans was reported by Hai and Malek in 2003 [10]. Since then, the efficacy and safety of highpower KTP laser vaporization has been demonstrated in multiple trials.…”

Section: Discussionmentioning

confidence: 99%

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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Photoselective Vaporization of the Prostate: Initial Experience with a New 80 W KTP Laser for the Treatment of Benign Prostatic Hyperplasia

Abstract: This pilot study indicates that PVP with the new 80 W KTP/532 laser is a simple, safe, and efficacious outpatient procedure for the treatment of obstructive BPH.

Cited by 163 publications

References 10 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

Comparison of 80 W versus 120 W 532 nm Laser Prostatectomy for BPH

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

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