Details

Autor(en) / Beteiligte

• REICH, OLIVER
• BACHMANN, ALEXANDER
• SIEBELS, MICHAEL
• HOFSTETTER, ALFONS
• STIEF, CHRISTIAN G.
• SULSER, TULLIO

Titel

HIGH POWER (80 W) POTASSIUM-TITANYL-PHOSPHATE LASER VAPORIZATION OF THE PROSTATE IN 66 HIGH RISK PATIENTS

Ist Teil von

• The Journal of urology, 2005, Vol.173 (1), p.158-160

Ort / Verlag

Hagerstown, MD: Elsevier Inc

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• Men with lower urinary tract symptoms secondary to benign prostatic hyperplasia who are at high cardiopulmonary risk or on oral anticoagulation are often denied surgical treatment. Potassium-titanyl-phosphate (KTP) laser vaporization at 80 W is a novel, rapidly emerging technique that promises instant hemostatic tissue ablation. We evaluated the merits of this procedure in patients at high risk and those on long-term anticoagulation. The prospective study included 66 patients with severe lower urinary tract symptoms who underwent 80 W KTP laser vaporization of the prostate. All patients were at high cardiopulmonary risk, having presented with an American Society of Anesthesiology score of 3 or greater. Additionally, 29 patients were being treated with ongoing oral anticoagulant therapy (26) or had a severe bleeding disorder (3). In all 66 patients KTP laser vaporization was performed successfully. Mean preoperative prostate volume ± SD was 49 ± 30 ml and mean operative time was 49 ± 19 minutes. No major complication occurred intraoperatively or postoperatively and no blood transfusion was required. Postoperatively 48 of 62 catheterized patients (77%) did not require irrigation. Average catheterization time was 1.8 ± 1.4 days. Two patients required reoperation due to recurrent urinary retention. At 1, 3, 6 and 12 months mean urinary peak flow increased from 6.7 ± 2 ml per second preoperatively to 18.5 ± 9, 18.9 ± 10, 19.2 ± 8 and 21.6 ± 7 ml per second, respectively. Mean International Prostate Symptom Score decreased from 20.2 ± 6 to 11.7 ± 7, 7.9 ± 7, 6.9 ± 5 and 6.5 ± 4, respectively. Our initial experience indicates that 80 W KTP laser vaporization is a virtually bloodless and, hence, safe but effective treatment option in seriously ill patients or those on oral anticoagulants.