High-power (80 W) potassium titanyl phosphate laser prostatectomy in 128 high-risk patients.

OBJECTIVE

To evaluate the safety and merits of 80 W potassium titanyl phosphate (KTP) laser prostatectomy in men with high cardiovascular or pulmonary risk, receiving oral anticoagulant medication, or with bleeding disorders.

METHODS

A prospective clinical trial was performed in 128 high-risk men with benign prostatic hyperplasia who underwent photoselective vaporisation of the prostate (PVP). The operation time, postoperative serum sodium and packed cell volume were recorded. The International Prostate Symptom Score (IPSS), maximal flow rate (Q(max)) and post-void residual urine volume (PVR) were measured at every follow-up visit.

RESULTS

In all patients, KTP laser prostatectomy was performed successfully. The mean (SD) operation time was 51.6 (22.8) min. No blood transfusions were required. No major complications occurred during surgery, and there was no mortality. The mean (SD) catheterisation time was 2.8 (1.6) days. IPSS decreased from 19.2 (6.1) before surgery to 11.5 (8.2), 7.8 (6.4), 6.7 (5.3) and 6.1 (4.6), respectively, at 1, 3, 6 and 12 months after. Q(max) increased from 7.0 (2.8) ml/s to 14.5 (9.3), 20.2 (11.5), 21.3 (8.6) and 24.8 (8.0) ml/s, respectively. PVR decreased from 168 (89) ml to 35 (29), 30 (26), 27 (21) and 23 (34) ml, respectively.

CONCLUSIONS

80 W KTP laser prostatectomy is a virtually bloodless, safe and effective procedure for men with high cardiovascular or pulmonary risk or bleeding disorders or taking oral anticoagulant medication.