Premium
Early Experiences of Contact Laser Vaporization of the Prostate using the 980 nm High Power Diode Laser for Benign Prostatic Hyperplasia
Author(s) -
MIYAZAKI Hideyo,
HIRANO Yoshikazu,
KATO Shinobu,
IORITANI Naomasa,
ICHIKAWA Takaharu,
TAKAMOTO Hitoshi,
HOMMA Yukio
Publication year - 2018
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/luts.12173
Subject(s) - medicine , prostate , urology , neck of urinary bladder , international prostate symptom score , urethral stricture , urinary retention , hyperplasia , surgery , lower urinary tract symptoms , urethra , urinary bladder , cancer
Objectives We report early experiences of contact laser vaporization of the prostate for symptomatic benign prostatic hyperplasia ( BPH ). Methods A total of 80 patients recruited at four institutions in J apan from A pril 2013 through S eptember 2014 underwent contact laser vaporization of the prostate using 980 nm high power diode laser with an end‐firing fiber in the contact mode. Patients were followed prospectively at 1 day, 2, 4, 8, 12, and 24 weeks, postoperatively per protocol, and at 1 and 2 years post‐protocol. Results Of 76 eligible patients, 64 (84.2%) achieved more than 50% decrease in I nternational P rostate S ymptom S core at 24 weeks (95% confidence interval: 74.0–91.6%), clearing the pre‐fixed non‐inferiority efficacy level to transurethral resection of the prostate (65%). Symptom scores, maximum flow rate, post‐void residual urine, and prostate volume showed significant improvements at 12 and 24 weeks after the surgery. Perioperative complications included transient urinary retention ( n = 20), retrograde ejaculation (5), bladder neck contracture (4), urethral stricture (3), stone in prostatic bed (3), bladder stone (2), bladder perforation (1), bladder deformity (1), and transient urgency incontinence (1). Urinary retention and bladder neck contracture occurred almost exclusively at one institution. Improved symptom scores, maximum flow rate, and post‐void residual urine observed at 24 weeks remained virtually unchanged at 1 and 2 years. Conclusions Early experience of contact laser vaporization in J apan showed efficacy comparable to transurethral resection of the prostate as a surgical procedure for BPH at 24 weeks. Long‐term efficacy of the procedure remains uncertain.