Functional outcome after laser vaporisation of the prostate with the KTP laser

被引:4
作者
Hamann M.F. [1 ,2 ]
Wild C. [1 ]
Seif C. [1 ]
Hautmann S. [1 ]
Jünemann K.P. [1 ]
Braun P.M. [1 ]
机构
[1] Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel
[2] Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel
来源
Der Urologe | 2007年 / 46卷 / 5期
关键词
Benign prostatic hyperplasia; Laser vaporisation; Potassium titanyl phosphate; Urodynamic;
D O I
10.1007/s00120-007-1311-z
中图分类号
学科分类号
摘要
Background. Treatment for bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia (BPH) impairs the quality of life. The potassium tintanyl phosphate (KTP) vaporisation of the prostate offers promising modalities in treatment of BOO. We prospectively determined the impact of KTP-lasertherapy on voiding function, quality of life and sexual function. Patients and methods. So far a total of n=123 patients complaining of syptomatic BPH were treated with an 80 watt Laser. N= 40 of them agreed to participate in the study and were evaluated prospectively. Preoperative pressure-flow-studies verified significant bladder outlet obstruction in all cases. Disease specific quality of life and sexual function were assessed using the International Prostate Symptom Score (IPSS) and International Inventory of Erectile Function (IIEF). Three months after treatment follow-up video-urodynamics were carried out to determine changements in pressure flow and bladder function. Results. All patients showed significant improvement after a hospital stay of 4,9 days. The maximum flow rate increased from 9,1 ml/sec preoperatively to 20,2 ml/sec and the amount of residual urine decreased from 98 ml preoperatively to 17 ml immediately after removal of the catheter. Urodynamics after the follow up period showed that the maximum urinary flow improved from 9.7 ml/s preoperatively to 17,6 ml/s and the volume of residual urine decreased from a median of 127.5 ml preoperatively to 45ml postoperatively. The IPSS and IIEF decreased from a median of 20,4 preoperatively to 8,16 and from a median of 14 preoperatively to 12,7 respectively. The pressure-flow study verified the desobstruction and showed a decline in detrusor pressure at maximum flow from 76,66 cm H2O to 33,79 cm H2O. The urethral opening pressure sank from 75.86 cm H 2O preoperatively to 37,51 cm H2O postoperatively. Conclusion. The potassium tintanyl phosphate (KTP) vaporisation of the prostate is a promising new method in the treatment of benign prostatic hyperplasia as shown by the data. Beside its low perioperativ and postoperative morbidity due to a high hemostatic property it offers a good tissue debulking effect. © 2007 Springer Medizin Verlag.
引用
收藏
页码:521 / 527
页数:6
相关论文
共 28 条
[1]  
Abrams P., Griffiths D.J., The assesment of prostatic obstruction from urodynamic measurements and from residual urine, Br J Urol, 51, pp. 129-134, (1979)
[2]  
Alschibaja M., May F., Treiber U., Et al., Transurethrale Resektion bei benigner Prostatahyperplasie. Aktuelle Entwicklungen, Urologe A, 44, pp. 499-504, (2005)
[3]  
Bachmann A., Reich O., Wyler S., Et al., Vaporisation of the prostate with the 80 W potassium titanyl phosphate (KTP) laser technique and 6 months follow-up after 70 procedures, Urologe A, 43, pp. 1262-1270, (2004)
[4]  
Bachmann A., Schurch L., Ruszat R., Et al., Photoselective Vaporisation (PVP) versus Transurethral Resektion of the Prostate (TURP): A prospective Bi-Center study of perioerative morbidity and early functional outcome, Eur Urol, 48, pp. 965-971, (2005)
[5]  
Chahal R., Sundaram S.K., Gogoi N.K., Assessment of voiding outcome, sexual function and quality of life two years following KTP/YAG hybrid laser prostatectomy, Urol Int, 65, pp. 125-129, (2000)
[6]  
Chute C.G., Panser L.A., Girman C.J., Et al., The prevalence of prostatism population based survey of urinary symptoms, J Urol, 150, pp. 85-89, (1993)
[7]  
Hai M.A., Malek R.S., Photoselective vaporisation of the prostate: Initial experience with a new 80 W KTP laser fort he treatment of benign prostatic hyperplasia, J Endourol, 17, pp. 93-96, (2003)
[8]  
Hald T., Urodynamics in benign prostatic hyperplasia. A survey, Prostate, 2, SUPPL., pp. 69-77, (1989)
[9]  
Homma Y., Imaio C., Takahashi S., Et al., Urinary symptoms and urodynamics in a normal elderly population, Scand J Urol Nephrol, 157, SUPPL., pp. 27-30, (1994)
[10]  
Jensen K.M.-E., Bruskewitz R.C., Madsen P.O., Urodynamic findings in elderly males without prostatic complaints, Urology, 24, pp. 211-213, (1984)