Comparative Analysis of Transurethral Resection of the Prostate and Side Firing Laser Prostatectomy(VLAP) / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Side firing laser prostatectomy(VLAP) is now considered as alternative promise of transurethral resection of the prostate(TURP). This study was designed to compare VLAP to conventional TURP in the efficacy and safety. MATERIALS AND METHODS: There was no significant differences in preoperative clinical characteristics between the TURP group and VLAP group. To evaluate the effectiveness and safety of VLAP, we compared the results of transurethral resection of prostate(TURP, n=115) to laser prostatectomy(VLAP, n=45) in international prostate symptom score(IPSS), maximal flow rate(Qmax), post-voiding residual urine at preoperative, after 1 month, 6 months and 12 months postoperatively. For the VLAP procedure, Nd YAG was used. Patient was treated with 600micrometer internal reflector fiber covered by crystal glass cadding(SideTrackTM). RESULTS: There was no statistically significant difference in the results between TURP group and VLAP group. TURP group; IPSS of preoperative, after 1 month, 6 months, 12 months was 23.8, 9.0, 9.1, 9.0 and Qmax was 7.8ml/s, 17.0ml/s, 17.1ml/s, 17.6ml/s and residual urine was 159.3ml, 52.7ml, 40.0ml, 34.6ml. VLAP group; IPSS of preoperative, after 1 month, 6 months, 12 months was 22.8, 9.7, 9.8, 9.3 and Qmax was 8.1ml/s, 16.0ml/s, 16.7ml/s, 17.1ml/s and residual urine was 135.7ml, 46.8ml, 34.5ml, 28.1ml. Postoperative period of catheter indwelling and hospitalization was shorter in VLAP group than TURP group(3.7+/-2.0 days vs 5.3+/-1.9 days, 4.5+/-1.6 days vs 6.8+/-3.5 days). CONCLUSIONS: VLAP has no siginificant complications such as postoperative bleeding, TURP syndrome. VLAP would be recommended as following 1) prostate weight is smaller, 2) physical status is poor, 3) anticoagulant treatment, 4) when patient wants more safe treatment. We had a good results by means of VLAP. The good results come from the use of internal reflecting type laser fiber. These results suggest that VLAP is considered the most promising alternative to TURP.