Photoselective vaporization of the prostate: initial experience with a new 80 W KTP laser for the treatment of benign prostatic hyperplasia

• Published in: Journal of endourology Vol. 17; no. 2; p. 93
• Main Authors: Hai, Mahmood A, Malek, Reza S
• Format: Journal Article
• Language: English
• Published: United States 01-03-2003
• Subjects: Aged; Humans; Laser Therapy - adverse effects; Laser Therapy - instrumentation; Male; Middle Aged; Pilot Projects; Postoperative Complications; Prostatic Hyperplasia - physiopathology; Prostatic Hyperplasia - surgery; Quality of Life; Transurethral Resection of Prostate - methods; Urination; Urodynamics
• ISSN: 0892-7790
• DOI: 10.1089/08927790360587414

To study the safety and efficacy of a new high-power potassium-titanyl-phosphate laser (KTP/532; Niagara PV trade mark laser system; Laserscope, San Jose, CA) for transurethral photoselective vaporization of benign obstructive prostate tissue.
The KTP/532 laser energy at 80 W was delivered by a 6F side-firing fiber through a 23F continuous-flow cystoscope. Photoselective vaporization of the prostate (PVP) using sterile water irrigation was performed under spinal anesthesia on an outpatient basis in 10 patients with a preoperative mean prostate volume of 41.37 +/- 18.5 cc (range 24-76.3 cc). The mean lasing time was 19.8 +/- 4.9 minutes.
Two patients experienced 1 to 7 days of mild dysuria, and one who was taking warfarin had mild transient hematuria, but none had urinary retention or other complications. The mean catheterization time was 17.2 +/- 9.6 hours (range 0-28 hours). At 1 year, the outcomes, which had showed significant improvement sustained throughout the follow-up, were as follows: mean American Urological Association Symptom Score decreased from 23.2 +/- 4.7 to 2.6 +/- 0.5 (88.8%), the mean quality of life score improved from 4.3 +/- 0.7 to 0.4 +/- 0.5 (90.7%), the mean peak urinary flow rate increased from 10.3 +/- 1.4 mL/sec to 30.7 +/- 5.8 mL/sec (198.1%), and the mean postvoiding residual volume decreased from 137.6 +/- 112.2 mL to 3.0 +/- 4.8 mL (97.8%). The mean prostate volume decreased by 27%.
This pilot study indicates that PVP with the new 80 W KTP/532 laser is a simple, safe, and efficacious outpatient procedure for the treatment of obstructive BPH.