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Proceedings Article

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

[+] Author Affiliations
M. Kleeman, Unyime O. Nseyo

Hunter Holmes McGuire VA Medical Ctr. (USA) and Virginia Commonwealth Univ. Medical School (USA)

Proc. SPIE 5312, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIV, 82 (July 13, 2004); doi:10.1117/12.537797
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From Conference Volume 5312

  • Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIV
  • Kenneth E. Bartels; Lawrence S. Bass; Werner T. W. de Riese; Kenton W. Gregory; Henry Hirschberg; Abraham Katzir; Nikiforos Kollias; Steen J. Madsen; Reza S. Malek; Karen M. McNally-Heintzelman; Keith D. Paulsen; David S. Robinson; Lloyd P. Tate, Jr.; Eugene A. Trowers; Brian J. Wong
  • San Jose, CA | January 24, 2004

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.

© (2004) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Citation

M. Kleeman and Unyime O. Nseyo
"High-power (80-w) KTP laser vaporization of the prostate in the management of urinary retention: long-term follow up", Proc. SPIE 5312, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIV, 82 (July 13, 2004); doi:10.1117/12.537797; http://dx.doi.org/10.1117/12.537797


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