Document Detail


Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial.
MedLine Citation:
PMID:  22591968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Hazem Elmansy; Abdulaziz Baazeem; Ahmed Kotb; Hesham Badawy; Essam Riad; Ashraf Emran; Mostafa Elhilali
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2012-05-15
Journal Detail:
Title:  The Journal of urology     Volume:  188     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-11     Completed Date:  2012-09-03     Revised Date:  2013-02-26    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  216-21     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, McGill University, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
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:
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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