Luis Miguel Clemente Ramos1. 1. Urology Department, CEMTRO Clinic, Madrid, Spain. urologia@clinicacemtro.com
Abstract
BACKGROUND: A clinical evaluation of the use of a 980 nm diode laser in the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH), focused on perioperatory morbidity and results in a short-term follow-up. METHODS: Fifteen patients were included in the study. All of them were evaluated by IPSS and Quality of Life (QoL) questionnaires, digital rectal examination, PSA, ultrasound scan and uroflowmetry. Prostate vaporization was performed with a laser of diode at 980 nm (Intermedic, Barcelona, Spain) using a 600 microns side-fire fiber. In the follow-up any event was recorded, as well as the IPSS and QoL scores and Qmax. RESULTS: Mean age of the patients was 66.7 years(45-75). The range of prostate volume was 20-76 cc (median 41.3 cc). Mean delivered energy was 161,012 kJ (78,3-243). No patient showed either a significant hematic loss or fluid absorption syndrome. A 22F urethral three-way catheter was inserted and removed between 12-40 hours in the postoperatory period. After a mean follow-up of 5,5 months (2-9) the average IPSS and QOL questionnaires scores changed, respectively, from 22,4 (19-26) and from 3 (2-4) to an average of 6,8 (1-13) (p0,01) and 1,4(0- 3), respectively, at the end of follow-up (p 0,01). Qmax increased from 6,4 ml/s (5-11,9) baseline to 19,7 ml/s (13,9-24 (p 0,01). No patient showed urinary incontinence. Retreatment was not needed though three patients needed a short-time catheterization (24 hours) after developing acute urinary retention in the first 48h hours. CONCLUSIONS: Our preliminary results suggest that prostate vaporization using 980 nm diode laser with output power up to 120 W, is effective and associated to minimal morbidity.
BACKGROUND: A clinical evaluation of the use of a 980 nm diode laser in the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH), focused on perioperatory morbidity and results in a short-term follow-up. METHODS: Fifteen patients were included in the study. All of them were evaluated by IPSS and Quality of Life (QoL) questionnaires, digital rectal examination, PSA, ultrasound scan and uroflowmetry. Prostate vaporization was performed with a laser of diode at 980 nm (Intermedic, Barcelona, Spain) using a 600 microns side-fire fiber. In the follow-up any event was recorded, as well as the IPSS and QoL scores and Qmax. RESULTS: Mean age of the patients was 66.7 years(45-75). The range of prostate volume was 20-76 cc (median 41.3 cc). Mean delivered energy was 161,012 kJ (78,3-243). No patient showed either a significant hematic loss or fluid absorption syndrome. A 22F urethral three-way catheter was inserted and removed between 12-40 hours in the postoperatory period. After a mean follow-up of 5,5 months (2-9) the average IPSS and QOL questionnaires scores changed, respectively, from 22,4 (19-26) and from 3 (2-4) to an average of 6,8 (1-13) (p0,01) and 1,4(0- 3), respectively, at the end of follow-up (p 0,01). Qmax increased from 6,4 ml/s (5-11,9) baseline to 19,7 ml/s (13,9-24 (p 0,01). No patient showed urinary incontinence. Retreatment was not needed though three patients needed a short-time catheterization (24 hours) after developing acute urinary retention in the first 48h hours. CONCLUSIONS: Our preliminary results suggest that prostate vaporization using 980 nm diode laser with output power up to 120 W, is effective and associated to minimal morbidity.