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High-power (80-w) KTP laser vaporization of the prostate in the management of urinary retention: long-term follow up
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Paper Abstract

Introduction and Objectives: We have previously reported the use of high-powered photoselective vaporization of the prostate (PVP) for patients in urinary retention due to benign prostatic hyperplasia (BPH). PVP is a relatively new treatment for bladder outlet obstruction due to BPH, using laser energy to vaporize obstructing prostatic tissue. This study investigates the long-term follow up of patients treated with PVP for urinary retention. Materials and Methods: All participants signed informed consent, and were treated with high power 80 W quasi-continuous wave potassium-titanyl-phosphate (KTP) laser. Ten patients underwent the procedure from December 2001 until the present. One patient was excluded from the study for failure to return for follow-up. Mean patient follow-up was nine months, maximum of twelve months. Results: The mean pre-operative gland size by trans-rectal ultrasound was 48 grams. Mean urethral length was 3.2 cm. Mean laser time was 48.2 minutes and the mean energy usage was 82.2 kJoules. There were no peri-operative complications such as sepsis or measurable postoperative bleeding. The preoperative AUA Symptom Score (AUASS) decreased from a mean of 22.6 preoperatively to 17 at nine months postoperatively (p = 0.032). The Quality of Life Score (QOL) decreased from 4.6 preoperatively to 3.25 at 12 months postoperatively (p = 0.26). The maximum urine flow rate increased from a mean of 7.7 cc/sec preoperatively to 14.5 cc/sec at six months follow-up (p = 0.03). Conclusions: This follow-up study suggests that HP-KTP has a durable response in patients treated specifically for retention. It significantly improved urine flow rate and symptom score, and had a trend towards improvement in subjective quality of life. HP-KTP prostatectomy should be considered in treating patients in retention, especially those with significant co-morbidities or taking anticoagulation.

Paper Details

Date Published: 13 July 2004
PDF: 5 pages
Proc. SPIE 5312, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIV, (13 July 2004); doi: 10.1117/12.537797
Show Author Affiliations
M. Kleeman, Hunter Holmes McGuire VA Medical Ctr. (United States)
Virginia Commonwealth Univ. Medical School (United States)
Unyime O. Nseyo M.D., Hunter Holmes McGuire VA Medical Ctr. (United States)
Virginia Commonwealth Univ. Medical School (United States)

Published in SPIE Proceedings Vol. 5312:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIV
Brian Jet-Fei Wong M.D.; Nikiforos Kollias; Kenton W. Gregory M.D.; Henry Hirschberg; Reza S. Malek M.D.; Abraham Katzir; David S. Robinson M.D.; Kenneth Eugene Bartels D.V.M.; Eugene A. Trowers M.D.; Werner T.W. de Riese; Lawrence S. Bass M.D.; Lloyd P. Tate V.D.M.; Steen J. Madsen; Keith D. Paulsen; Karen M. McNally-Heintzelman, Editor(s)

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