| Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial. | |
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MedLine Citation:
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PMID: 22591968 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To our knowledge we report the first single center, prospective, randomized study comparing holmium laser enucleation and high performance GreenLight™ prostate photoselective vaporization as surgical treatment of prostatic adenomas greater than 60 ml. MATERIALS AND METHODS: A total of 80 patients with a large prostatic adenoma were randomly assigned to surgical treatment with holmium laser enucleation or photoselective vaporization. International Prostate Symptom Score, International Index of Erectile Function-15, maximum flow rate, post-void residual urine, serum prostate specific antigen and transrectal ultrasound volume were recorded. RESULTS: Patient baseline characteristics were similar for holmium laser enucleation and photoselective vaporization. Operative time and catheter removal time were almost equal in the 2 groups (p = 0.7 and 0.2, respectively). Eight vaporization cases were converted to transurethral prostate resection or holmium laser enucleation intraoperatively due to bleeding. A significantly higher maximum flow rate and lower post-void residual urine were noted in holmium laser cases during the entire followup (at 1 year each p = 0.02). However, no significant difference in International Prostate Symptom Score, quality of life or International Index of Erectile Function-15 was detected. Prostate volume and serum PSA decreased 78% and 88% in the holmium laser group, and 52% and 60% in the vaporization group, respectively. CONCLUSIONS: Holmium laser enucleation and photoselective vaporization are effective for lower urinary tract symptoms due to a large prostatic adenoma. Early subjective functional results (maximum flow rate and post-void residual urine) of holmium laser enucleation appear to be superior to those of photoselective vaporization. In our hands cases intended to be treated with photoselective vaporization were at 22% risk of conversion to another modality. This could reflect our determination to vaporize to the capsule in all vaporization cases. |
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Authors:
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Hazem Elmansy; Abdulaziz Baazeem; Ahmed Kotb; Hesham Badawy; Essam Riad; Ashraf Emran; Mostafa Elhilali |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2012-05-15 |
Journal Detail:
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Title: The Journal of urology Volume: 188 ISSN: 1527-3792 ISO Abbreviation: J. Urol. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-06-11 Completed Date: 2012-09-03 Revised Date: 2013-02-26 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 216-21 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, McGill University, Montreal, Quebec, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Follow-Up Studies Humans Laser Therapy / instrumentation* Lasers, Solid-State / therapeutic use* Male Prospective Studies Prostate / surgery, ultrasonography* Prostatic Hyperplasia / complications, surgery*, ultrasonography Transurethral Resection of Prostate / methods* Treatment Outcome Urinary Bladder Neck Obstruction / etiology, physiopathology, surgery* Urodynamics Volatilization |
| Comments/Corrections | |
Comment In:
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J Urol. 2013 Feb;189(2):774-5
[PMID:
22986042
]
J Urol. 2013 Feb;189(2):775 [PMID: 23260565 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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