Abstract
The objective of this study is to compare the efficacy and safety of diode laser enucleation of the prostate (DiLEP) with plasmakinetic enucleation of the prostate (PKEP) for symptomatic benign prostatic hyperplasia (BPH) patients with large prostate (volume > 80 ml). From January 2013 to June 2014, 80 consecutive patients were randomized treated with DiLEP (n = 40) or PKEP (n = 40). Perioperative and postoperative outcome data were assessed during a 1-year follow-up. There were no significant preoperative differences between the two surgical groups. The mean prostate volumes in the DiLEP and PKEP groups were 98.6 and 93.3 ml, respectively. DiLEP was equivalent to PKEP in improvement in International Prostate Symptom Score (IPSS), quality of life scores, and maximum flow rate. Compared with PKEP, patients treated with DiLEP showed a lower risk of blood loss (P < 0.01), shorter bladder irrigation and catheterization times (P < 0.01), as well as shorter hospital stays (P < 0.01). Moreover, the DiLEP group was significantly superior to bipolar plasmakinetic group in the irritative symptoms. However, the operation time of the DiLEP group was longer than that of PKEP group (P = 0.02). Both DiLEP and PKEP are safe and effective methods for the treatment of BPH in large prostates (volume > 80 ml). Compared with PKEP, DiLEP provides a decreased risk of hemorrhage, reduced bladder irrigation, and catheterization times, as well as shorter hospital stays.
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References
Bushman W (2009) Etiology, epidemiology, and natural history of benign prostatic hyperplasia. Urol Clin N Am 36:403–415
Bhansali M, Patankar S, Dobhada S et al (2009) Management of large (>60 g) prostate gland: PlasmaKinetic superpulse (bipolar) versus conventional (monopolar) transurethral resection of the prostate. J Endourol 23:141–145
Cornu JN, Ahyai S, Bachmann A et al (2014) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67:1066–1096
Kavanagh LE, Jack GS, Lawrentschuk N (2011) Prevention and management of TURP-related hemorrhage. Nat Rev Urol 8:504–514
Alschibaja M, May F, Treiber U et al (2006) Recent improvements in transurethral high-frequency electrosurgery of the prostate. BJU Int 97:243–246
Wendt-Nordahl G, Huckele S, Honeck P et al (2007) 980-nm diode laser: a novel laser technology for vaporization of the prostate. Eur Urol 52:1723–1728
Wezel F, Wendt-Nordahl G, Huck N et al (2010) New alternatives for laser vaporization of the prostate: experimental evaluation of a 980-, 1,318- and 1,470-nm diode laser device. World J Urol 28:181–186
Xu A, Zou Y, Li B et al (2013) A randomized trial comparing diode laser enucleation of the prostate with plasmakinetic enucleation and resection of the prostate for the treatment of benign prostatic hyperplasia. J Endourol 27:1254–1260
Oelke M, Bachmann A, Descazeaud A et al (2013) EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol 64:118–140
Pfitzenmaier J, Gilfrich C, Pritsch M et al (2008) Vaporization of prostates of > or =80 mL using a potassium-titanyl-phosphate laser: midterm-results and comparison with prostates of <80 mL. BJU Int 102:322–327
Tan AH, Gilling PJ, Kennett KM et al (2003) A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol 170:1270–1274
Chen YB, Chen Q, Wang Z et al (2013) A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year follow up. J Urol 189:217–222
Neill MG, Gilling PJ, Kennett KM et al (2006) Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia. Urology 68:1020–1024
Liao N, Yu J (2012) A study comparing plasmakinetic enucleation with bipolar plasmakinetic resection of the prostate for benign prostatic hyperplasia. J Endourol 26:884–888
Naspro R, Suardi N, Salonia A et al (2006) Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 50:563–568
Liu C, Zheng S, Li H et al (2010) Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol 184:2440–2445
Zhao Z, Zeng G, Zhong W et al (2010) A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol 58:752–758
Chen CH, Chiang PH, Lee WC et al (2012) High-intensity diode laser in combination with bipolar transurethral resection of the prostate: a new strategy for the treatment of large prostates (>80 ml). Lasers Surg Med 44:699–704
Kaplan SA (2014) Re: high-intensity diode laser in combination with bipolar transurethral resection of the prostate: a new strategy for the treatment of large prostate (>80 ml). J Urol 191:743
Shaker HS, Saafan A, Yassin MM et al (2015) Safety and efficacy of quartz head contact laser ablation for large prostates using 980-nm laser: a comparative prospective study against that for small- and medium-sized prostates. Urology 85:452–456
Yang SS, Hsieh CH, Chiang IN et al (2013) Prostate volume did not affect voiding function improvements in diode laser enucleation of the prostate. J Urol 189:993–998
Leonardi R (2009) Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique. Prostate Cancer Prostatic Dis 12:277–280
Chen CH, Chiang PH, Chuang YC et al (2010) Preliminary results of prostate vaporization in the treatment of benign prostatic hyperplasia by using a 200-W high-intensity diode laser. Urology 75:658–663
Netsch C, Bach T, Pohlmann L et al (2012) Comparison of 120–200 W 2 mum thulium:yttrium-aluminum-garnet vapoenucleation of the prostate. J Endourol 26:224–229
Netsch C, Pohlmann L, Herrmann TR et al (2012) 120-W 2-microm thulium:yttrium-aluminium-garnet vapoenucleation of the prostate: 12-month follow-up. BJU Int 110:96–101
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This work was supported by Grants from the National Natural Science Foundation of China (81172426) and Shanghai Education Commission Research and Innovation projects (12ZZ034).
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Gang Wu and Zhe Hong contributed equally to this work.
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Wu, G., Hong, Z., Li, C. et al. A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up. Lasers Med Sci 31, 599–604 (2016). https://doi.org/10.1007/s10103-016-1883-1
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DOI: https://doi.org/10.1007/s10103-016-1883-1