Photoselective vaporization of prostate: five-year outcomes of entire clinic patient population.

OBJECTIVES: To evaluate the 5-year clinical outcomes and durability of photoselective vaporization of the prostate (PVP) in the treatment of benign prostatic hyperplasia with obstruction.
METHODS: The patient outcomes were evaluated at 5 years for the first 321 patients who had undergone PVP from November 2000 to June 2003 at 1 institution. Complete follow-up data were available for 246 of the 321 patients. The baseline and 5-year evaluations included symptom (American Urological Association) and quality-of-life measures, prostate-specific antigen, transrectal ultrasound-determined prostate volume, maximal flow rate, and repeat treatment rate.
RESULTS: The average pre- and postoperative results and average percentage of improvement per patient were as follows: American Urological Association symptom score, 24.0 +/- 5.3, 5.0 +/- 3.0, and 79% (P < .01); quality-of-life score, 4.2 +/- 0.9, 0.8 +/- 0.8, and 80% (P < .01); maximal flow rate, 8.6 +/- 3.5, 21.1 +/- 6.3, and 172% (P < .01); prostate-specific antigen, 3.2 +/- 3.7, 2.2 +/- 2.0, and 10% (P < .01); transrectal ultrasound-determined prostate volume, 54.7 +/- 29.9, 42.7 +/- 22.5, and 17% (P < .01); and postvoid residual urine volume, 170 +/- 229, 28 +/- 57, and 77% (P < .01). Of the 246 patients followed up for 5 years, 19 were treated with repeat PVP because of reobstruction due to large glands, and 3 underwent transurethral incision of the bladder neck, for an overall retreatment rate of 8.9%. Three patients were treated for bladder neck contracture.
CONCLUSIONS: The results of this study have established the long-term durability of PVP for the treatment of benign prostatic hyperplasia with obstruction, demonstrating sustained clinical effects similar to, or better than, those reported for other procedures.