Abstract
This study examined efficacy and safety of the 980 nm side-firing diode laser operating at a power of 100 W in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). Patients were selected for surgery on the basis of maximum urinary flow rate (Qmax) ⩽15 ml/s or transvesically measured post-voiding residual volume (PVR) >100 ml in conjunction with an International Prostate Symptom Score (IPSS) >7. Laser therapy was conducted under spinal anaesthesia. Qmax, IPSS, prostate volume, PVR, IPSS-Quality of Life (QoL) questionnaire and ejaculatory function were measured at baseline and at 1, 3, 6 and 12 months post-laser therapy. A total of 52 consecutive patients aged 52–65 years with mean (s.d.) prostate volume of 45.14 (9.15) g were treated. All patients were able to leave the hospital at a mean (s.d.) of 5 (2) h after the procedure. Mean (s.d.) follow-up was 100 (75.49) days. A significant reduction in IPPS was reported at 1 month (P<0.0001) and this was maintained through to 6 months. Significant durable improvements in Qmax, PVR and IPSS-QoL score were also reported for all patients (P<0.0001). No severe complications were reported, including any cases of urinary incontinence or significant irritative symptoms. None of the patients complained of a worsening of erectile function. This early experience in a pilot study with the 980 nm diode laser seems promising in the short-term and long-term outcome is being monitored.
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Muntener M, Aelling S, Kuettel R, Gehrlach C, Sulser T, Strobel RT . Sexual function after transurethral resection of the prostate (TURP): results of an independent prospective multicentre assessment of outcome. Eur Urol 2007; 52: 510–515.
Rassweiler J, Teber D, Kuntz R, Hofmann R . Complications of transurethral resection of the prostate (TURP)-incidence, management, and prevention. Eur Urol 2006; 50: 969–979.
Costello AJ, Lusaya DG, Crowe HR . Transurethral laser ablation of the prostate: long-term results. World J Urol 1995; 13: 119–122.
Malek RS, Kuntzman RS, Barrett DM . Photoselective potassium-titanyl-phosphate laser vaporization of the benign obstructive prostate: observations on long-term outcomes. J Urol 2005; 174 (4 Part 1): 1344–1348.
Wendt-Nordahl G, Huckele S, Honeck P, Alken P, Knoll T, Michel MS et al. 980-nm Diode laser: a novel laser technology for vaporization of the prostate. Eur Urol 2007; 52: 1723–1728.
Seitz M, Sroka R, Gratzke C, Schlenker B, Schlenker B, Steinbrecher V et al. The diode laser: a novel side-firing approach for laser vaporisation of the human prostate—immediate efficacy and 1-year follow-up. Eur Urol 2007; 52: 1717–1722.
Muir G, Gómez Sancha F, Bachmann A, Choi B, Collins E, de la Rosette J et al. Techniques and training with Greenlight HPS 120-W laser therapy of the prostate: position paper. Eur Urol 2008; 7 (Suppl): 370–375.
Bachmann A, Schürch L, Ruszat R, Wyler SF, Seifert HH, Müller A et al. Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 2005; 48: 965–971.
Gilling PJ, Aho TF, Frampton CM, King CJ, Fraundorfer MR . Holmium laser enucleation of the prostate: results at 6 years. Eur Urol 2008; 53: 744–749.
Vavassori I, Hurle R, Vismara A, Manzetti A, Valenti S . Holmium laser enucleation of the prostate combined with mechanical morcellation: two years of experience with 196 patients. J Endourol 2004; 18: 109–112.
Ruszat R, Seitz M, Wyler SF, Lehmann K, Abe C, Bonkat G et al. GreenLight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures. Eur Urol 2008; 54: 893–901.
Peterson MD, Matlaga BR, Kim SC, Lehmann K, Abe C, Bonkat G et al. Holmium laser enucleation of the prostate for men with urinary retention. J Urol 2005; 174: 998–1001.
Te AE, Malloy TR, Stein BS, Ulchaker JC, Nseyo UO, Hai MA et al. Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia: 12-month results from the first United States multicenter prospective trial. J Urol 2004; 172 (4 Part 1): 1404–1408.
Meng F, Gao B, Fu Q, Chen J, Liu Y, Shi B et al. Change of sexual function in patients before and after Ho:YAG laser enucleation of the prostate. J Androl 2007; 28: 259–261.
Abdel-Khalek M, El-Hammady S, Ibrahiem el-H . A 4-year follow-up of a randomized prospective study comparing transurethral electrovaporization of the prostate with neodymium: YAG laser therapy for treating benign prostatic hyperplasia. BJU Int 2003; 91: 801–805.
Kabalin JN . Complications of laser treatment in urologic surgery. In: Taneja S, Smith RB, Ehrlich RM (eds). Complications of Urologic Surgery, 3rd edn, Elsevier: St Louis, MO, 2001.
Bachmann A, Ruszat R, Wyler S, Reich O, Seifert HH, Müller A et al. Photoselective vaporization of the prostate: the Basel experience after 108 procedures. Eur Urol 2005; 47: 798–804.
Kuntz RM, Ahyai S, Lehrich K, Fayad A . Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 2004; 172: 1012–1016.
Kuo R, Paterson R, Siqueira T, Watkins SL, Simmons GR, Steele RE et al. Holmium laser enucleation of the prostate: morbidity in a series of 206 patients. Urology 2003; 62: 59–63.
Sulser T, Reich O, Wyler S, Ruszat R, Casella R, Hofstetter A et al. Photoselective KTP laser vaporization of the prostate: first experiences with 65 procedures. J Endourol 2004; 18: 976–981.
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Leonardi, R. 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 (2009). https://doi.org/10.1038/pcan.2009.5
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DOI: https://doi.org/10.1038/pcan.2009.5
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