scholarly journals Photoselective vaporization of the prostate using GreenLight 120-W lithium triborate laser to treat symptomatic benign prostatic hyperplasia: A single-centre prospective study

2013 ◽  
Vol 7 (3-4) ◽  
pp. e193-6 ◽  
Author(s):  
Hisham A. Mosli ◽  
Taha A. Abdel-Meguid ◽  
Mohammad H. Abdulwahhab ◽  
Ahmad Al-Sayyad ◽  
Hasan M. Farsi ◽  
...  

Objective: We evaluated the safety and efficacy of photoselective vaporization of the prostate (PVP) using GreenLight 120-W lithium triborate (LBO) laser to treat symptomatic small-to-medium sized benign prostatic hyperplasia (BPH).Methods: This prospective non-controlled observational study included symptomatic BPH men ≥50 years with international prostate symptom score (IPSS) ≥14, prostate volume (PV) ≤80 cc and maximum flow rate (Q-max) ≤15 mL/s. PVP was performed using the GreenLight 120-W LBO laser machine. Patients were assessed at baseline and postoperatively at discharge, 2 weeks, and 3, 6 and 12 months. We measured changes in IPSS, PV, PSA, Q-max, post-void residual (PVR), hemoglobin (Hb), serum sodium (Na+) and reported complications. Statistical significance was p < 0.05.Results: The study included 103 men with mean age of 67 (±standarddeviation) ±9.7 years. Thirty patients were on indwelling urethral catheters for refractory urinary retention and 12 on ongoing anticoagulants. The mean baseline IPSS, PV, PSA, Q-max and PVR parameters significantly improved at follow-up (p < 0.001; each). Mean measurements at baseline versus at six months were: IPSS 25.6 ± 4.2 vs. 7.4±2.3; PV 44.6 ± 9.2 vs. 21.6 ± 6.3 cc (51.6% reduction); Q-max 5.8 ± 3.4 vs. 20.4 ± 4.8 mL/s; PVR 110 ± 40 vs. 35 ± 9 cc. Mean baseline Hb and serum Na+ declined nonsignificantly (p > 0.05) at discharge and at 2 weeks. No patient needed a blood transfusion. Secondary procedures were needed in 2 patients for urethral and bladder neck strictures. The re-treatment rate for residual adenoma was 0.97%.Conclusion: PVP using the GreenLight 120-W LBO laser to treat small-to-medium sized symptomatic BPH demonstrated significant improvements in efficacy parameters and high safety profile within 12 months of follow-up. The procedure entails good hemostasis with minimal blood loss even in patients receiving ongoing anticoagulants.

2017 ◽  
Vol 11 (2) ◽  
pp. 103-109 ◽  
Author(s):  
Priyanka Rai ◽  
Alok Srivastava ◽  
Ishwar R. Dhayal ◽  
Sanjeet Singh

Objectives: To compare bipolar vaporization of prostate (BPVP) with photoselective vaporization (PVP) of prostate in the surgical management of benign prostatic hyperplasia in terms of safety, efficacy and cost effectiveness. Methods: Data was analyzed retrospectively for patients who underwent either PVP or BPVP between August 2012 to July 2014 for prostate size ≤ 80 ml. Preoperative and postoperative period values along with details like operative time, blood loss, hospitalization days, catheter removal time, blood transfusion and etc., were noted down. International prostatic symptom score, quality of life scores, post void residue, and maximum flow rate were recorded preoperatively and postoperatively at each follow-up visit. Follow-up was performed at 1, 3, 6 ,12 and 18 months. Results: Similar preoperative characteristics were observed in all the study arms. Hemoglobin drop, transfusion rate, catheter time and hospital days were similar in both the groups. The follow-up data indicates sustainable significant improvement in international prostatic symptom score, quality of life, post void residue and maximum flow rate in both the groups. As expected the cost of the procedure was significantly more in PVP group as compared to BPVP group (p < 0.01). Neither group had severe perioperative complications and no blood transfusion was required in both the groups. Conclusion: Both PVP and BPVP were safe and effective alternatives in men requiring surgery for benign prostatic hyperplasia including patients who were on anticoagulants. Additionally, BPVP has the advantage of being significantly cheaper and therefore it can be more useful in developing countries.


2016 ◽  
Vol 15 (1) ◽  
pp. 17-21
Author(s):  
Sakhawat Mahmud Khan ◽  
Md Matiar Rahaman Khan ◽  
Shahin Akhter ◽  
Md Mizanur Rahman

Background: Lower urinary tract symptoms suggestive of symptomatic Benign Prostatic Hyperplasia (BPH) are a very common disease in elderly men .The incidence of benign prostatic hyperplasia is age related.Objectives: To compare the efficacy and safety of Tamsulosin and Terazosin in the treatment of symptomatic Benign Prostatic Hyperplasia.Methods: This was a prospective study carried out in the Department of Urology, Chittagong Medial College Hospital, Chittagong, Bangladesh during the period of July to December 2014. Total 40 patients of 45-80 years of age were consequently selected according to inclusion criteria. After completion of baseline clinical evaluation and investigations, participants were divided into two groups, group A and group B. Group A (n=20) was given Terazosin 1mg daily for 3 days at bed time and then 2 mg daily at bed time for 2 months. Group B (n=20) was given Tamsulosin, 0.4 mg per day for 2 months. Efficacy was evaluated of each group after 2 month follow up and lastly a comparison was made between them. The parameters monitored were International Prostate Symptoms Score (IPSS) Maximum urine flow rate (Qmax) and Post Voidal Residual Volume (PVR). Tamsulosin 0.4 mg and Terazosin 2 mg once daily for 8 weeks both are effective in relieving symptoms of BPH but Tamsulosin is superior to Terazosin in improvement of total IPSS (p<0.001) and Qmax (p<0.01) PVR (p<0.01) at the end point.Results: Outcome of parameters at follow up after 2 months. Tamsulosin group showed significant improvement of IPSS (p<0.05) PVR (p<0.001) and Qmax (p<0.001) than Terazosin. The incidence of adverse events by administration of Tamsulosin was less than that by Terazosin.Conclusion: Tamsulosin appears to have more efficacy and safety than Terazosin in symptomatic BPH.Chatt  Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 17-21


2014 ◽  
Vol 8 (9-10) ◽  
pp. 595 ◽  
Author(s):  
Mert Ali Karadag ◽  
Kursat Cecen ◽  
Aslan Demir ◽  
Ramazan Kocaaslan ◽  
Fatih Altunrende

Introduction: We evaluate the efficacy and outcomes of plasmakinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH).Methods: A total of 183 patients with BPH underwent plasmakinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization.Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 ± 3.819 and Group 2 had a 18.15 ± 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 ± 1.049 days, and in Group 2 it was 2.64 ± 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR).Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year.


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