Document Detail


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.
MedLine Citation:
PMID:  12780836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the safety, efficacy and durability of neodymium (Nd):YAG laser prostatectomy with transurethral electrovaporization of the prostate (TUVP) for treating benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: From March 1995 to March 1997, 180 patients with bladder outlet obstruction secondary to BPH were randomized equally either to Nd:YAG laser therapy or TUVP. Laser therapy combined two different techniques, side-fire coagulation of the lateral lobes and contact vaporization of the median lobe. Before treatment the two groups had a comparable International Prostate Symptom Score (IPSS), quality-of-life score (QoL), maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and prostate and adenoma volume. In all, 62 and 78 patients completed the 1, 2, 3 and 4-year follow-up from the laser and TUVP groups, respectively. RESULTS: At each follow-up, the IPSS, QoL, Qmax and PVR were significantly better and more durable in the TUVP than in the laser group. In the TUVP and laser groups respectively, at the 4-year follow-up the mean value of the IPSS was 3.7 vs 11.9, the QoL 1.3 vs 3.1, the Qmax 21.4 vs 13.6 mL/s and the PVR 25.1 vs 64.6 mL (all P < 0.001). The mean prostate and adenoma volume were significantly lower after TUVP than after laser therapy (P < 0.001) at the 1- and 4-year follow-up, with final values of 27.9 vs 35.9 and 11.7 vs 20 mL (both P < 0.001) for the TUVP and laser groups, respectively. Retrograde ejaculation was significantly more common after TUVP (63%) than after laser therapy (18%; P < 0.001). Impotence was reported in 8% of men after TUVP and in none after laser therapy (P = 0.040). The re-operation rate was 12% after TUVP and 38% after laser treatment (P < 0.001). CONCLUSION: These 4-year follow-up results confirm that TUVP is significantly more effective and durable than the Nd:YAG laser for treating BPH. Residual obstructing adenoma was the main cause of failure in the laser group, which reflects the inadequacy of laser therapy for removing the adenoma.
Authors:
M Abdel-Khalek; S El-Hammady; El-H Ibrahiem
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  BJU international     Volume:  91     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-03     Completed Date:  2003-07-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-5     Citation Subset:  IM    
Affiliation:
Urology and Nephrology Center, Mansoura University, Egypt.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Electrosurgery / adverse effects,  methods*
Erectile Dysfunction / etiology
Follow-Up Studies
Humans
Laser Therapy / adverse effects,  methods*
Male
Middle Aged
Neodymium
Postoperative Complications / etiology
Prospective Studies
Prostatectomy / adverse effects,  methods*
Prostatic Hyperplasia / surgery*
Quality of Life
Treatment Outcome
Chemical
Reg. No./Substance:
7440-00-8/Neodymium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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