ABSTRACT
<p><b>OBJECTIVE</b>To compare the therapeutic effects of the greenlight photoselective vaporization of prostate (PVP) and transurethral electrovaporization resection of prostate (TUVP) for the treatment of symptomatic benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>One hundred and sixty-three cases of BPH were treated with PVP and TUVP. All patients were followed up with International Prostatic Symptom Score (IPSS), quality of life (QOL), blood loss, operative time, indwelling catheterization, mean Qmax, residual urinary volume (RUV) and operative complications.</p><p><b>RESULTS</b>IPSS, QOL, Qmax and RUV were significantly improved after either of the procedures (P < 0.05), no significant difference in the improvement of subjective symptoms and objective signs had been noted with the different procedure (P > 0.05). Mean operative time was (37 +/- 15) min for TUVP and (45 +/- 28) min for PVP, the resection time was longer for PVP than TUVP (P > 0.05), but the intraoperative bleeding and catheterization time were less for PVP than TUVP (P < 0.05). Postoperative complications were less for PVP than TUVP (P < 0.05). The incidence of hematuria in TUVP group had been 41.4%, and urinary irritation after PVP group was 55.2% (P < 0.05).</p><p><b>CONCLUSIONS</b>PVP has the same therapeutic effect as TUVP and less adverse side effects than TUVP. It is a new technique for the treatment symptomatic BPH.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Follow-Up Studies , Laser Therapy , Prostate , Pathology , General Surgery , Prostatic Hyperplasia , General Surgery , Quality of Life , Transurethral Resection of Prostate , Methods , Treatment OutcomeABSTRACT
<p><b>AIM</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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 BPH.</p>