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Clinical Question
Is photoselective vaporization of the prostate (PVP) effective for the
treatment of benign prostatic hyperplasia (BPH)?
Bottom Line
PVP is considered as a high satisfaction rate by patient and a
minimal postoperative complication. Hence, PVP is a novel, safe, effective
and minimal invasive treatment for patients with symptomatic BPH.
Reference
Photoselective vaporization of the prostate in the treatment of benign
prostatic hyperplasia.Fu WJ, Hong BF, Yang Y, Cai W, Gao JP, Wang CY, Wang
XX.Chin Med J (Engl). 2005 Oct 5;118(19):1610-4.
Study Design
Cohort Study
Synopsis
The treatment of symptomatic benign prostatic hyperplasia (BPH) remains a
challenge for most urologic surgeons. They studied a cumulative cohort of
patients with symptomatic benign prostatic hyperplasia (BPH) who underwent
photoselective vaporization of the prostate (PVP) and evaluated the efficacy
and safety of this procedure. A total of 196 patients with lower urinary
tract obstruction symptoms secondary to BPH were treated using laser
vaporization of the prostate under sacral canal anesthesia at our
institutions. The therapeutic results were assessed using following
variables: the safety and efficacy of sacral anesthesia, blood loss,
operative time, indwelling catheterization. Preoperative and perioperative
parameters were evaluated in the international prostate symptom score (IPSS),
quality of life score (QoL), maximal urinary flow rate (Qmax), post-void
residual urine volume (PVR) and the change of sexual function. Patients were
also assessed for 3-month follow up. PVP was performed successfully for all
patients. There were 195 patients under sacral anesthesia and 1 patient
under epidural anesthesia. Mean operative time was (45.2 +/- 18.5) minutes.
The mean IPSS decreased from (26.6 +/- 3.2) to (5.6 +/- 1.4) and the QoL
score decreased from (5.7 +/- 0.4) to (1.6 +/- 0.5), respectively (P <
0.05), while mean Qmax increased from (6.7 +/- 2.5) ml/s preoperatively to
(19.6 +/- 2.4) ml/s, PVR decreased from 158.4 to 25.8 ml, respectively (P <
0.05). Average catheterization time was (1.8 +/- 0.9) days. There was no
significant blood loss or fluid absorption during the period of PVP.
Complications consisted of transient dysuria in 3 patients (1.5%), delayed
gross hematuria in 5 patients (2.5%), respectively. Significant improvement
in clinical outcomes were noted as early as 3 months after PVP treatment.
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