ABSTRACT
There are few data on the safety and efficacy of laser photoselective vaporization [LVP] in elderly men. We compared the safety and efficacy of LVP for the treatment of symptomatic benign prostatic hyperplasia [BPH] in men >/= 75 years, who we defined as elderly, to those <75 years. Safety and efficacy outcomes in elderly men undergoing LVP for lower urinary tract symptoms secondary to BPH from 2005 to 2012 were compared with men <75 years. Differences between-groups in demographics, perioperative outcomes, complications, and postoperative changes in International Prostate Symptom Score [I-PSS] were calculated. Of 202 patients, 49 [24%] were elderly [range: 75-95 years] and 153 [76%] were <75 years. Preoperatively, elderly men were more likely to have heart disease [35% vs. 20%, P = 0.03], gross hematuria [6.1% vs. 0.7%, P = 0.05], urinary retention [57% vs. 41%, P = 0.07], and take anti-coagulants [61% vs. 35%, P = 0.002]. Elderly men had a longer median length of stay [1 day vs. 0 day, P = 0.001]. There were no significant between-group differences in transfusion frequency [4.4% vs. 0.7%, P = 0.14] or Clavien III complications [2% vs. 2.6%, P = 1.0]. One month postsurgery, elderly patients reported smaller median decreases in I-PSS [5.5 vs. 9, P = 0.02] and urinary bother [1 point vs. 2, P = 0.03] compared with preoperative values. At till 9 months follow-up, there were no significant between-group differences in median I-PSS or urinary bother scores. Despite a higher prevalence of preoperative comorbidity and urinary retention, elderly LVP patients experienced perioperative safety and shorter term efficacy outcomes comparable to younger men