Twelve-Month Follow-up Results of Photoselective Vaporization of the Prostate With a 980-nm Diode Laser for Treatment of Benign Hyperplasia

PURPOSE: This study was conducted with the use of 12 months of follow-up data to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 980-nm diode laser for the treatment of symptomatic benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The clinical data of 84 men with symptomatic BPH who underwent PVP with the 980-nm K2 diode laser between March 2010 and October 2011 were retrospectively analyzed. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR), were assessed and compared with preoperative baseline values. RESULTS: Mean patient age was 72.4+/-6.5 years, and mean preoperative prostate volume was 47.2+/-16.3 g. Mean operative time was 23.3+/-19.1 minutes, and total amount of energy was 128+/-85 kJ. Mean catheterization time was 23.7+/-5.9 hours. At 1 month, significant improvements were noted in IPSS (11.5+/-6.8), QoL score (2.2+/-1.3), Qmax (12.9+/-6.5 mL/s), and PVR (41.2+/-31.3 mL). Three months after surgery, all postoperative follow-up parameters showed significant improvements, and the 6- and 12-month data showed sustained improvement of postoperative follow-up parameters. Bladder neck strictures were observed in 10.7% of the patients and urge incontinence in 16.6%. CONCLUSIONS: PVP using a K2 diode laser is an effective procedure for the treatment of lower urinary tract symptoms secondary to BPH. PVP leads to an immediate and sustained improvement of subjective and objective voiding parameters. Surgeons should be vigilant for postoperative bladder neck stricture and urge incontinence.

Initial Experiences with a 980 nm Diode Laser for Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia

PURPOSE: This study was conducted to analyze the efficacy of photoselective vaporization of the prostate (PVP) with the use of a 980 nm diode laser for benign prostatic hyperplasia (BPH) according to postoperative period. MATERIALS AND METHODS: Data were collected from 96 patients who were diagnosed with BPH and who underwent PVP with the 980 nm K2 diode laser. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and post-void residual volume (PVR), were assessed and compared with preoperative baseline values. RESULTS: The mean prostate volume was 45.3+/-15.6 g, the mean operative time (lasing time) was 22.9+/-18.3 minutes, the total amount of energy was 126+/-84 kJ, and the Foley catheter maintenance period after PVP was 24.8+/-5.6 hours. At 1 month, significant improvements were noted in IPSS (11.7+/-6.6), QoL score (2.3+/-1.1), Qmax (12.7+/-6.1 ml/sec), and PVR (41.9+/-30.5 ml). After 3 months, all follow-up parameters showed significant improvements that were sustained throughout a period of 6 months after PVP. CONCLUSIONS: PVP using a K2 diode laser is a minimally invasive and effective surgical method for improvement of BPH and is associated with minimal morbidity.

Analysis of the Results of ABO-Incompatible Kidney Transplantation: In Comparison with ABO-Compatible Kidney Transplantation

PURPOSE: The number of patients waiting for kidney transplantation is incessantly increasing, but the number of cadaveric kidney transplantations or ABO-compatible donors is so insufficient that ABO-incompatible kidney transplantation is being performed as an alternative. There are overseas studies and research showing that the 5-year survival rate and 5-year graft survival rate of ABO-incompatible kidney transplantation are not much different from those of ABO-compatible kidney transplantation. However, domestic research on the subject is rare. Therefore, we report the results of 22 ABO-incompatible kidney transplantation cases performed in our hospital. MATERIALS AND METHODS: This research was from 22 patients in our hospital who underwent ABO-incompatible kidney transplantation from 15 February 2007 to 20 May 2010. RESULTS: As yet, there have been no donor graft losses and no deaths after transplantation. The results of the two groups were analyzed by analysis of covariance of the creatinine value of the recipients at 6 months after the operation, corrected for the preoperative value in order to statistically identify whether there were differences in renal function after the operation between ABO-compatible and ABO-incompatible kidney transplantation. The results of the analysis of covariance showed no statistical difference in renal function after the operation between the two groups. CONCLUSIONS: Even though there were not many cases, our initial results for ABO-incompatible kidney transplantation were positive. Considering the increasing number of patients waiting for kidney transplantation, longer-term domestic research studies of ABO-incompatible kidney transplantation are necessary.

Robotic-Assisted Radical Prostatectomy Using da VinciTM Surgical Robotic System: Initial Korean Experience / 대한비뇨기과학회지

PURPOSE: In 2004, a joint effort was undertaken between Dong-a University Hospital, Busan, Korea and Singapore General Hospital, Singapore, to promote laparoscopic radical prostatectomy (LRP) to yet another level by enhancing the human performance using a master-slave manipulator, the da VinciTM System. Herein, we report our initial experience of employing robotic telepresent technology to perform a LRP. MATERIALS AND METHODS: A 6-port modified transperitoneal approach was used. The da VinciTM System (Intuitive Surgical, Inc., California) consists of three components: a surgeon console, a robotic manipulator and a vision cart. Cable-driven mechanical "Endowrist" instruments are capable of delivering a complete range of motion at the instrument tips, allowing a total of 6 degrees of freedom. RESULTS: Five robotic-assisted LRP were performed. The mean patient age PSA and Gleason score were 65 years, 7.8ng/ml and 6.2, respectively. Overall, the system functioned well, without significant intraoperative errors. The mean operative time was 185 minutes in 2 patients with preservation of the neurovascular bundle, and 154 minutes in 2 patients with non-nerve sparing. In one patient, a bilateral pelvic lymphadenectomy was performed, with an operative time of 195 minutes. The mean blood loss and hospital stay were 245cc and 2.5 days, respectively. All patients maintained continence at 3 month follow-up. CONCLUSIONS: Intuitive hand-eye coordination, superb depth of perception and "Endowrist" instruments allowed tissue handling and suturing quite feasible during the LRP. Continuous effort is underway to further the surgical experience and advances in robotic technology. We believe robotic surgical systems will greatly facilitate and improve the LRP procedure.