Tags

Type your tag names separated by a space and hit enter

A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up.
BJU Int. 2010 Apr; 105(7):964-9.BI

Abstract

OBJECTIVE

To compare the potassium-titanyl-phosphate Greenlight(TM) 80-W laser ablation system for photovaporization of the prostate (PVP; Laserscope, San Jose, CA, USA) with transurethral resection of the prostate (TURP), as many technologies have been proposed as equivalent or superior to TURP without gaining widespread acceptance, due to lack of data from randomized trials.

PATIENTS AND METHODS

In all, 120 patients were randomized to undergo either TURP or PVP after a full urological evaluation, which was repeated at 1, 3, 6 and 12 months after surgery. Irrigation use, duration of catheterization (DOC), length of hospital stay (LOS), blood loss, cost and operative time were also assessed.

RESULTS

Both groups showed a significant increase in mean (sd) maximum urinary flow rate from baseline (P < 0.05); in the TURP group from 8.9 (3.0) to 19.4 (8.7) mL/s (154%), and in the PVP group from 8.8 (2.5) to 18.6 (8.2) mL/s (136%). The International Prostate Symptom Score (IPSS) decreased from 25.4 (5.7) to 10.9 (9.4) in the TURP group (53%), and from 25.3 (5.9) to 8.9 (7.6) in the PVP group (61%). The trends were similar for the bother and Quality of Life scores. There was no difference in sexual function as measured by Baseline Sexual Function Questionnaires. The DOC was significantly less in the PVP than the TURP group (P < 0.001), with a mean (range) of 13 (0-24) h vs 44.7 (6-192) h. The situation was similar for LOS (P < 0.001), with a mean (range) of 1.09 (1-2) and 3.6 (3-9) days in the PVP and TURP groups, respectively. Adverse events and complications were less frequent in the PVP group. Costs were also 22% less in the PVP group.

CONCLUSIONS

This trial shows that PVP is an effective technique when compared to TURP, producing equivalent improvements in flow rates and IPSS with the advantages of markedly reduced LOS, DOC and adverse events. A long-term follow-up is being undertaken to ensure durability of these results.

Authors+Show Affiliations

Department of Urology, Royal Melbourne Hospital, Melbourne University, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19912196

Citation

Bouchier-Hayes, David M., et al. "A Randomized Trial of Photoselective Vaporization of the Prostate Using the 80-W Potassium-titanyl-phosphate Laser Vs Transurethral Prostatectomy, With a 1-year Follow-up." BJU International, vol. 105, no. 7, 2010, pp. 964-9.
Bouchier-Hayes DM, Van Appledorn S, Bugeja P, et al. A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up. BJU Int. 2010;105(7):964-9.
Bouchier-Hayes, D. M., Van Appledorn, S., Bugeja, P., Crowe, H., Challacombe, B., & Costello, A. J. (2010). A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up. BJU International, 105(7), 964-9. https://doi.org/10.1111/j.1464-410X.2009.08961.x
Bouchier-Hayes DM, et al. A Randomized Trial of Photoselective Vaporization of the Prostate Using the 80-W Potassium-titanyl-phosphate Laser Vs Transurethral Prostatectomy, With a 1-year Follow-up. BJU Int. 2010;105(7):964-9. PubMed PMID: 19912196.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up. AU - Bouchier-Hayes,David M, AU - Van Appledorn,Scott, AU - Bugeja,Pat, AU - Crowe,Helen, AU - Challacombe,Ben, AU - Costello,Anthony J, Y1 - 2009/11/12/ PY - 2009/11/17/entrez PY - 2009/11/17/pubmed PY - 2010/5/6/medline SP - 964 EP - 9 JF - BJU international JO - BJU Int VL - 105 IS - 7 N2 - OBJECTIVE: To compare the potassium-titanyl-phosphate Greenlight(TM) 80-W laser ablation system for photovaporization of the prostate (PVP; Laserscope, San Jose, CA, USA) with transurethral resection of the prostate (TURP), as many technologies have been proposed as equivalent or superior to TURP without gaining widespread acceptance, due to lack of data from randomized trials. PATIENTS AND METHODS: In all, 120 patients were randomized to undergo either TURP or PVP after a full urological evaluation, which was repeated at 1, 3, 6 and 12 months after surgery. Irrigation use, duration of catheterization (DOC), length of hospital stay (LOS), blood loss, cost and operative time were also assessed. RESULTS: Both groups showed a significant increase in mean (sd) maximum urinary flow rate from baseline (P < 0.05); in the TURP group from 8.9 (3.0) to 19.4 (8.7) mL/s (154%), and in the PVP group from 8.8 (2.5) to 18.6 (8.2) mL/s (136%). The International Prostate Symptom Score (IPSS) decreased from 25.4 (5.7) to 10.9 (9.4) in the TURP group (53%), and from 25.3 (5.9) to 8.9 (7.6) in the PVP group (61%). The trends were similar for the bother and Quality of Life scores. There was no difference in sexual function as measured by Baseline Sexual Function Questionnaires. The DOC was significantly less in the PVP than the TURP group (P < 0.001), with a mean (range) of 13 (0-24) h vs 44.7 (6-192) h. The situation was similar for LOS (P < 0.001), with a mean (range) of 1.09 (1-2) and 3.6 (3-9) days in the PVP and TURP groups, respectively. Adverse events and complications were less frequent in the PVP group. Costs were also 22% less in the PVP group. CONCLUSIONS: This trial shows that PVP is an effective technique when compared to TURP, producing equivalent improvements in flow rates and IPSS with the advantages of markedly reduced LOS, DOC and adverse events. A long-term follow-up is being undertaken to ensure durability of these results. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/19912196/A_randomized_trial_of_photoselective_vaporization_of_the_prostate_using_the_80_W_potassium_titanyl_phosphate_laser_vs_transurethral_prostatectomy_with_a_1_year_follow_up_ L2 - https://doi.org/10.1111/j.1464-410X.2009.08961.x DB - PRIME DP - Unbound Medicine ER -