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Prostatectomy using different lasers for the treatment of benign prostate hyperplasia in aging males

Identifieur interne : 000461 ( Main/Exploration ); précédent : 000460; suivant : 000462

Prostatectomy using different lasers for the treatment of benign prostate hyperplasia in aging males

Auteurs : Wei-Chang Lee [Taïwan] ; Yu-Hsiang Lin [Taïwan] ; Chen-Pang Hou [Taïwan] ; Phei-Lang Chang [Taïwan] ; Chien-Lun Chen [Taïwan] ; Horng-Heng Juang [République populaire de Chine] ; Ke-Hung Tsui [Taïwan]

Source :

RBID : PMC:3832386

Descripteurs français

English descriptors

Abstract

Purpose

Endoscopic lasers have become a treatment option for benign prostate hyperplasia (BPH). The study reported here sought to elucidate the benefits and drawbacks of different laser systems in the treatment of patients with BPH.

Methods

The study enrolled 741 patients diagnosed with lower urinary tract symptoms secondary to BPH during the period January 2005 to December 2011. The techniques used in the study were photoselective vaporization of the prostate, thulium laser prostatectomy, and diode laser prostatectomy. Patients were assigned to one of three groups according to the type of laser treatment they received. Outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life, maximal urinary flow rate, post-voiding residual urine volume, and prostate-specific antigen (PSA) level.

Results

The baseline characteristics of patients who received diode laser prostatectomy show a significant elevated risk and high American Society of Anesthesiology score (P=0.001). Operative time and catheter removal time differed significantly between the three groups (P=0.001). No cases were converted to transurethral resection of the prostate intraoperatively due to bleeding (P=0.142). Among the three groups, there were no significant differences in maximal flow rate, lower post-void residual urine, and postoperative PSA level during the entire follow-up period (P<0.05). Further, no significant differences in postoperative IPSS, quality of life, or bladder neck contracture (P=0.23) were observed. However, a significant difference was observed with regard to prolonged use of Foley catheters and prolonged hospital stay among patients in the diode laser group (P=0.001).

Conclusion

Laser prostatectomies are effective in dealing with lower urinary tract symptoms. Early subjective functional results (maximal flow rate, IPSS, and post-void residual urine) appeared the same as those obtained following laser prostatectomy. Thus, it appears that lasers are safe and effective as long as the patients are carefully selected for treatment.


Url:
DOI: 10.2147/CIA.S52697
PubMed: 24255595
PubMed Central: 3832386


Affiliations:

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Le document en format XML

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<term>Laser Therapy (methods)</term>
<term>Logistic Models</term>
<term>Male</term>
<term>Outcome Assessment (Health Care) (methods)</term>
<term>Prostatectomy (methods)</term>
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<term>Prostatectomie ()</term>
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<title>Purpose</title>
<p>Endoscopic lasers have become a treatment option for benign prostate hyperplasia (BPH). The study reported here sought to elucidate the benefits and drawbacks of different laser systems in the treatment of patients with BPH.</p>
</sec>
<sec>
<title>Methods</title>
<p>The study enrolled 741 patients diagnosed with lower urinary tract symptoms secondary to BPH during the period January 2005 to December 2011. The techniques used in the study were photoselective vaporization of the prostate, thulium laser prostatectomy, and diode laser prostatectomy. Patients were assigned to one of three groups according to the type of laser treatment they received. Outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life, maximal urinary flow rate, post-voiding residual urine volume, and prostate-specific antigen (PSA) level.</p>
</sec>
<sec>
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<p>The baseline characteristics of patients who received diode laser prostatectomy show a significant elevated risk and high American Society of Anesthesiology score (
<italic>P</italic>
=0.001). Operative time and catheter removal time differed significantly between the three groups (
<italic>P</italic>
=0.001). No cases were converted to transurethral resection of the prostate intraoperatively due to bleeding (
<italic>P</italic>
=0.142). Among the three groups, there were no significant differences in maximal flow rate, lower post-void residual urine, and postoperative PSA level during the entire follow-up period (
<italic>P</italic>
<0.05). Further, no significant differences in postoperative IPSS, quality of life, or bladder neck contracture (
<italic>P</italic>
=0.23) were observed. However, a significant difference was observed with regard to prolonged use of Foley catheters and prolonged hospital stay among patients in the diode laser group (
<italic>P</italic>
=0.001).</p>
</sec>
<sec>
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<p>Laser prostatectomies are effective in dealing with lower urinary tract symptoms. Early subjective functional results (maximal flow rate, IPSS, and post-void residual urine) appeared the same as those obtained following laser prostatectomy. Thus, it appears that lasers are safe and effective as long as the patients are carefully selected for treatment.</p>
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<name sortKey="De La Pe A, E" uniqKey="De La Pe A E">E de la Peña</name>
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<author>
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<name sortKey="Gross, A" uniqKey="Gross A">A Gross</name>
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<author>
<name sortKey="Bach, T" uniqKey="Bach T">T Bach</name>
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<author>
<name sortKey="Wendt Nordahl, G" uniqKey="Wendt Nordahl G">G Wendt-Nordahl</name>
</author>
<author>
<name sortKey="Michel, Ms" uniqKey="Michel M">MS Michel</name>
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<author>
<name sortKey="Herrmann, Tr" uniqKey="Herrmann T">TR Herrmann</name>
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</author>
<author>
<name sortKey="Haecker, A" uniqKey="Haecker A">A Haecker</name>
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<name sortKey="Michel, Ms" uniqKey="Michel M">MS Michel</name>
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<li>République populaire de Chine</li>
<li>Taïwan</li>
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<name sortKey="Lee, Wei Chang" sort="Lee, Wei Chang" uniqKey="Lee W" first="Wei-Chang" last="Lee">Wei-Chang Lee</name>
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<name sortKey="Chang, Phei Lang" sort="Chang, Phei Lang" uniqKey="Chang P" first="Phei-Lang" last="Chang">Phei-Lang Chang</name>
<name sortKey="Chen, Chien Lun" sort="Chen, Chien Lun" uniqKey="Chen C" first="Chien-Lun" last="Chen">Chien-Lun Chen</name>
<name sortKey="Hou, Chen Pang" sort="Hou, Chen Pang" uniqKey="Hou C" first="Chen-Pang" last="Hou">Chen-Pang Hou</name>
<name sortKey="Lin, Yu Hsiang" sort="Lin, Yu Hsiang" uniqKey="Lin Y" first="Yu-Hsiang" last="Lin">Yu-Hsiang Lin</name>
<name sortKey="Tsui, Ke Hung" sort="Tsui, Ke Hung" uniqKey="Tsui K" first="Ke-Hung" last="Tsui">Ke-Hung Tsui</name>
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<name sortKey="Juang, Horng Heng" sort="Juang, Horng Heng" uniqKey="Juang H" first="Horng-Heng" last="Juang">Horng-Heng Juang</name>
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