PURPOSE: To assess and compare postoperative prostate volume changes following 532-nm laser vaporization (LV) and transurethral resection of the prostate (TURP). To investigate whether differences in volume reduction are associated with differences in clinical outcome. METHODS: In this prospective, non-randomized study, 184 consecutive patients undergoing 120 W LV (n = 98) or TURP (n = 86) were included. Transrectal three-dimensional ultrasound and planimetric volumetry of the prostate were performed preoperatively, after catheter removal, 6 weeks, 6 and 12 months. Additionally, clinical outcome parameters were recorded. Mann-Whitney U test and analysis of covariance were utilized for statistical analysis. RESULTS: Postoperatively, a significant prostate volume reduction was detectable in both groups. However, the relative volume reduction was lower following LV (18.4 vs. 34.7 %, p < 0.001). After 6 weeks, prostate volumes continued to decrease in both groups, yet differences between the groups were less pronounced. Nonetheless, the relative volume reduction remained significantly lower following LV (12 months 43.3 vs. 50.3 %, p < 0.001). All clinical outcome parameters improved significantly in both groups. However, the maximum flow rate (Q max) and prostate-specific antigen (PSA) reduction were significantly lower following LV. Subgroup analyses revealed significant differences only if the initial prostate volume was >40 ml. Re-operations were necessary in three patients following LV. CONCLUSIONS: The modest but significantly lower volume reduction following LV was associated with a lower PSA reduction, a lower Q max and more re-operations. Given the lack of long-term results after LV, our results are helpful for preoperative patient counseling. Patients with large prostates and no clear indication for the laser might not benefit from the procedure.
PURPOSE: To assess and compare postoperative prostate volume changes following 532-nm laser vaporization (LV) and transurethral resection of the prostate (TURP). To investigate whether differences in volume reduction are associated with differences in clinical outcome. METHODS: In this prospective, non-randomized study, 184 consecutive patients undergoing 120 W LV (n = 98) or TURP (n = 86) were included. Transrectal three-dimensional ultrasound and planimetric volumetry of the prostate were performed preoperatively, after catheter removal, 6 weeks, 6 and 12 months. Additionally, clinical outcome parameters were recorded. Mann-Whitney U test and analysis of covariance were utilized for statistical analysis. RESULTS: Postoperatively, a significant prostate volume reduction was detectable in both groups. However, the relative volume reduction was lower following LV (18.4 vs. 34.7 %, p < 0.001). After 6 weeks, prostate volumes continued to decrease in both groups, yet differences between the groups were less pronounced. Nonetheless, the relative volume reduction remained significantly lower following LV (12 months 43.3 vs. 50.3 %, p < 0.001). All clinical outcome parameters improved significantly in both groups. However, the maximum flow rate (Q max) and prostate-specific antigen (PSA) reduction were significantly lower following LV. Subgroup analyses revealed significant differences only if the initial prostate volume was >40 ml. Re-operations were necessary in three patients following LV. CONCLUSIONS: The modest but significantly lower volume reduction following LV was associated with a lower PSA reduction, a lower Q max and more re-operations. Given the lack of long-term results after LV, our results are helpful for preoperative patient counseling. Patients with large prostates and no clear indication for the laser might not benefit from the procedure.
Authors: Aurélien Descazeaud; Gregoire Robert; Abdel Rahmene Azzousi; Charles Ballereau; Bertrand Lukacs; Olivier Haillot; Olivier Dumonceau; Marian Devonec; Marc Fourmarier; Christian Saussine; Alexandre de la Taille Journal: BJU Int Date: 2009-12-22 Impact factor: 5.588
Authors: Sascha A Ahyai; Peter Gilling; Steven A Kaplan; Rainer M Kuntz; Stephan Madersbacher; Francesco Montorsi; Mark J Speakman; Christian G Stief Journal: Eur Urol Date: 2010-06-11 Impact factor: 20.096
Authors: Thomas Hermanns; Tullio Sulser; Markus Fatzer; Martin K Baumgartner; Julien M Rey; Markus W Sigrist; Hans-Helge Seifert Journal: Eur Urol Date: 2008-03-27 Impact factor: 20.096
Authors: Pierre-Alain Hueber; Tal Ben-Zvi; Daniel Liberman; Naeem Bhojani; Gagan Gautam; Tom Deklaj; Mark Katz; Kevin C Zorn Journal: Can J Urol Date: 2012-10 Impact factor: 1.344
Authors: Marian S Wettstein; Cédric Poyet; Nico C Grossmann; Christian D Fankhauser; Etienne X Keller; Marko Kozomara; Salome Meyer; Tullio Sulser; Alexander Müller; Thomas Hermanns Journal: World J Urol Date: 2016-01-16 Impact factor: 4.226
Authors: Benedikt Kranzbühler; Oliver Gross; Christian D Fankhauser; Marian S Wettstein; Nico C Grossmann; Lukas J Hefermehl; Matthias Zimmermann; Alexander Müller; Daniel Eberli; Tullio Sulser; Cédric Poyet; Thomas Hermanns Journal: World J Urol Date: 2016-06-23 Impact factor: 4.226