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Clinical Outcomes of Greenlight Laser (Photoselective Vaporization of the Prostate) for Obstructive Benign Prostatic Hyperplasia
Michael R. Hermans, MD, King S. Cofffield, MD.
Scott and White Clinic, Temple, TX,
Background: Photoselective vaporization of the prostate (PVP) by Greenlight laser has recently become popular as an alternative to standard transurethral resection of the prostate.We have recently added this treatment modality to our practice and our initial results are presented.
Methods: An IRB approved prospective case series of 105 consecutive men who underwent PVP between September 2004 and March 2006.The men were divided into three groups based upon preoperative bladder management: Group N-catheter free (87 men), Group Y- indwelling Foley catheter (8 men) and Group CIC-performing clean intermittent catheterization (10 men).Preoperative data points obtained were: age, AUA symptom score (IPSS), AUA bother score, Sexual Health Inventory for Men (SHIM) score,Prostate Specific Antigen (PSA), serum creatinine, flow rate,postvoid ultrasound residual urine, and transrectal ultrasound prostate volume.The total number of joules used for vaporization was recorded. Postoperative data points at 6 and 12 months obtained were: AUA symptom score (IPSS), AUA bother score, SHIM score, flow rate, and postvoid ultrasound residual urine.
Results: Data summarized in table. | Situation | Group | IPSS | Bother | SHIM | Flow rate | Residual | | Preop | N | 21.3 | 4.03 | 11.2 | 8.54 ml/sec | 128 ml | | | Y | 20.6 | 5.2 | 7.6 | | | | | CIC | 23.6 | 4.4 | 10.3 | | | | 6 month postop | N | 6.6 | 1.36 | 9.5 | 14.3 ml/sec | 36.2 ml | | | Y | 8.7 | 1.7 | 22 | 9.4 ml/sec | 67 ml | | | CIC | 5 | 3 | | 16.3 ml/sec | 195 ml | | 12 month postop | N | 8.6 | 2.07 | 9.45 | 12.2 ml/sec | 28.4 ml |
Conclusions: PVP was effective in improving all voiding parameters at 6 and 12 months postoperatively. Sexual function was maintained and improved significantly for men with indwelling foley catheters.PVP should be considered by all urologists to treat obstructive BPH.
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