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MP-06.07: Comparison of Outcomes between Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate (PVP) and Holmium Laser Enucleation of the Prostate (HoLEP): An Interim Analysis
MODERATED POSTER SESSIONS
MP-06.06, Table Plasmakinetic (n ⴝ 51) Pre-op 6 Months 1 Year 3 Years 5 Years 6 Years 7 Years
I-PSS 19.9⫾7 4.9⫾5* 4.9⫾5* 4.5⫾5* 4.9⫾5* 5.4⫾5* 5.2⫾5*
QoL 4.2⫾1 1.1⫾1* 1.0⫾1* 1.1⫾1* 0.8⫾1* 1.0⫾1* 0.9⫾1*
TURP (n ⴝ 25) Q-max 8.4⫾2 18.8⫾11* 21.7⫾11* 21.0⫾12* 20.0⫾9* 18.9⫾9* 18.4⫾9*
I ⴝ PSS 19⫾6 5.5⫾5* 4.7⫾4* 4.1⫾4* 5.4⫾5 5.8⫾5 5.8⫾4
QoL 3.7⫾1 1.0⫾1* 0.8⫾1* 1.1⫾1* 1.2⫾1 1.2⫾1 1.2⫾1
Q-max 8.0⫾3 19.9⫾10 21.8⫾14 20.7⫾12 20.5⫾11 19.8⫾11 21.6⫾14
Results are expressed in Mean ⫾SD. *p value ⬍ 0.001.
in each group had urethral stricture and 1 in each group required re-TURP. Conclusions: PVP was found to be effective and safe treatment modality for patients with BPH. Ongoing anticoagulation did not influence the results or the complications rate.
up. In the TURP group 1 patient required TURP (4%) in 7 years. Conclusions: Plasmakinetic vaporisation produced reduced intra operative bleeding and has no risk of TUR syndrome due to saline irrigant.
MP-06.06 A Propective Randomised Study between Transurehtral Vaporisation Using Plasmakinetic Energy and Transurethral Resection of Prostate: Long Term Follow-up Chandrasekar P, Kapasi F, Virdi J Princess Alexandra Hospital, Harlow, UK
MP-06.07 Comparison of Outcomes between Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate (PVP) and Holmium Laser Enucleation of the Prostate (HoLEP): An Interim Analysis Cho M, Bae J, Ku J, Oh S, Kim S, Paick J Department of Urology, Seoul National University Hospital, Seoul, South Korea
Introduction and Objectives: A prospective randomised study was conducted to evaluate the safety and efficacy of Plasmakinetic™ energy that produces vaporisation of tissue immersed in isotonic saline against standard transurethral resection of the prostate. Materials and Methods: Randomisation was commenced in October 1998 with ratio of 2:1 (Plasmakinetic: TURP). Seventy-six (22 with retention of urine) so far has been enrolled in this study. Fifty-one patients underwent vaporisation and 25 treated by standard transurethral resection. Intra operative parameters were operating time, blood loss, fluid absorption during TURP, serum sodium and haemoglobin. Results: Operative duration was similar in both the groups. There was no significant difference in pre and post-operative sodium and creatinine. Mean blood loss in plasmakinetic group was 251ml (range 49-1000) and TURP group 497ml (range50-1750). Fluid absorption in TURP group was ⬍500ml. One patient in plasmakinetic group had prolonged catheterisation for 5 days; 3 patients had mild stress incontinence lasting three months and 2 patients required TURP (4%) in 7 years. Eleven people had died due to other medical illness and 3 had developed malignancies and 2 were lost to follow
S70
Introduction and Objective: We evaluated the clinical outcomes after potassium-titanyl-phosphate photoselective vaporization of the prostate (PVP) or holmium laser enucleation of the prostate (HoLEP) in men with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). Materials and Methods: A total of 103 men (mean age 67.6) with LUTS/BPH were analysed in the retrospective study. PVP and HoLEP were performed on 60 and 43 men, respectively. After the HoLEP, all retrieved tissue was collected and weighed. As for the PVP, the vaporized volume was calculated as the preoperative volume minus the immediate postoperative volume plus the volume defect using the TRUS. The efficacy was assessed at 1-, 3-, and 6-months postoperatively using the International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual urine volume (PVR), and 3-day frequencyvolume charts (FVC). Results: There was no significant difference between the two groups regarding the baseline parameters except for the serum PSA. For the PVP and HoLEP group, mean preoperative total prostate were 58.2 ⫾ 24.4 g and 50.1 ⫾ 16.5 g,
respectively. There was no significant difference in the removed proportion (vaporized volume or enucleated5 weight/ total prostate volume) between the PVP and HoLEP groups (30.2 ⫾ 9.7% vs. 26.0 ⫾ 14.8%, p ⫽ 0.024). The catheter time and hospitalization were significantly longer in the HoLEP group than in the PVP group (p ⬍ 0.001). According to the IPSS, FVC and uroflowmetry with PVR, the symptom parameters improved significantly after the operation in both groups (p ⬍ 0.05), which was not significantly different between the two groups during the entire period of follow-up (p ⬎ 0.05). Complications such as bladder neck contracture or urethral stricture occurred in 6.7% of the PVP group and 7.0% of the HoLEP group. Conclusions: Both PVP and HoLEP appear to be equally effective in improving micturition. The catheter time and hospital stay were longer in the HoLEP group, but there was no difference in the morbidity such as complication between the two. HoLEP as well as PVP may be a potential replacement of the transurethral resection of the prostate, the gold standard for managing patients with LUTS/ BPH. MP-06.08 120W Greenlight Laser Prostatectomy: Results from an Ongoing Prospective Worldwide Multicentre Study Bachmann A1, Woo H2, Gomez Sancha F3, Collins E4, de la Rosette J5, Muir G6, Tabatabaei S7, Choi B8, Reich O9 1 Department of Urology, University Hospital Basel, Basel, Switzerland; 2Department of Urology, Westmead Hospital, The University of Sydney, Sydney, Australia; 3 Institute of Advanced Urological Surgery, Madrid, Spain; 4California Urological Services, San Francisco, USA; 5Department of Urology, Academic Medical Center, University of Amsterdam, The Netherlands; 6Department of Urology,
UROLOGY 74 (Supplment 4A), October 2009
MP-06.06, Table Plasmakinetic (n ⴝ 51) Pre-op 6 Months 1 Year 3 Years 5 Years 6 Years 7 Years
I-PSS 19.9⫾7 4.9⫾5* 4.9⫾5* 4.5⫾5* 4.9⫾5* 5.4⫾5* 5.2⫾5*
QoL 4.2⫾1 1.1⫾1* 1.0⫾1* 1.1⫾1* 0.8⫾1* 1.0⫾1* 0.9⫾1*
TURP (n ⴝ 25) Q-max 8.4⫾2 18.8⫾11* 21.7⫾11* 21.0⫾12* 20.0⫾9* 18.9⫾9* 18.4⫾9*
I ⴝ PSS 19⫾6 5.5⫾5* 4.7⫾4* 4.1⫾4* 5.4⫾5 5.8⫾5 5.8⫾4
QoL 3.7⫾1 1.0⫾1* 0.8⫾1* 1.1⫾1* 1.2⫾1 1.2⫾1 1.2⫾1
Q-max 8.0⫾3 19.9⫾10 21.8⫾14 20.7⫾12 20.5⫾11 19.8⫾11 21.6⫾14
Results are expressed in Mean ⫾SD. *p value ⬍ 0.001.
in each group had urethral stricture and 1 in each group required re-TURP. Conclusions: PVP was found to be effective and safe treatment modality for patients with BPH. Ongoing anticoagulation did not influence the results or the complications rate.
up. In the TURP group 1 patient required TURP (4%) in 7 years. Conclusions: Plasmakinetic vaporisation produced reduced intra operative bleeding and has no risk of TUR syndrome due to saline irrigant.
MP-06.06 A Propective Randomised Study between Transurehtral Vaporisation Using Plasmakinetic Energy and Transurethral Resection of Prostate: Long Term Follow-up Chandrasekar P, Kapasi F, Virdi J Princess Alexandra Hospital, Harlow, UK
MP-06.07 Comparison of Outcomes between Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate (PVP) and Holmium Laser Enucleation of the Prostate (HoLEP): An Interim Analysis Cho M, Bae J, Ku J, Oh S, Kim S, Paick J Department of Urology, Seoul National University Hospital, Seoul, South Korea
Introduction and Objectives: A prospective randomised study was conducted to evaluate the safety and efficacy of Plasmakinetic™ energy that produces vaporisation of tissue immersed in isotonic saline against standard transurethral resection of the prostate. Materials and Methods: Randomisation was commenced in October 1998 with ratio of 2:1 (Plasmakinetic: TURP). Seventy-six (22 with retention of urine) so far has been enrolled in this study. Fifty-one patients underwent vaporisation and 25 treated by standard transurethral resection. Intra operative parameters were operating time, blood loss, fluid absorption during TURP, serum sodium and haemoglobin. Results: Operative duration was similar in both the groups. There was no significant difference in pre and post-operative sodium and creatinine. Mean blood loss in plasmakinetic group was 251ml (range 49-1000) and TURP group 497ml (range50-1750). Fluid absorption in TURP group was ⬍500ml. One patient in plasmakinetic group had prolonged catheterisation for 5 days; 3 patients had mild stress incontinence lasting three months and 2 patients required TURP (4%) in 7 years. Eleven people had died due to other medical illness and 3 had developed malignancies and 2 were lost to follow
S70
Introduction and Objective: We evaluated the clinical outcomes after potassium-titanyl-phosphate photoselective vaporization of the prostate (PVP) or holmium laser enucleation of the prostate (HoLEP) in men with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). Materials and Methods: A total of 103 men (mean age 67.6) with LUTS/BPH were analysed in the retrospective study. PVP and HoLEP were performed on 60 and 43 men, respectively. After the HoLEP, all retrieved tissue was collected and weighed. As for the PVP, the vaporized volume was calculated as the preoperative volume minus the immediate postoperative volume plus the volume defect using the TRUS. The efficacy was assessed at 1-, 3-, and 6-months postoperatively using the International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual urine volume (PVR), and 3-day frequencyvolume charts (FVC). Results: There was no significant difference between the two groups regarding the baseline parameters except for the serum PSA. For the PVP and HoLEP group, mean preoperative total prostate were 58.2 ⫾ 24.4 g and 50.1 ⫾ 16.5 g,
respectively. There was no significant difference in the removed proportion (vaporized volume or enucleated5 weight/ total prostate volume) between the PVP and HoLEP groups (30.2 ⫾ 9.7% vs. 26.0 ⫾ 14.8%, p ⫽ 0.024). The catheter time and hospitalization were significantly longer in the HoLEP group than in the PVP group (p ⬍ 0.001). According to the IPSS, FVC and uroflowmetry with PVR, the symptom parameters improved significantly after the operation in both groups (p ⬍ 0.05), which was not significantly different between the two groups during the entire period of follow-up (p ⬎ 0.05). Complications such as bladder neck contracture or urethral stricture occurred in 6.7% of the PVP group and 7.0% of the HoLEP group. Conclusions: Both PVP and HoLEP appear to be equally effective in improving micturition. The catheter time and hospital stay were longer in the HoLEP group, but there was no difference in the morbidity such as complication between the two. HoLEP as well as PVP may be a potential replacement of the transurethral resection of the prostate, the gold standard for managing patients with LUTS/ BPH. MP-06.08 120W Greenlight Laser Prostatectomy: Results from an Ongoing Prospective Worldwide Multicentre Study Bachmann A1, Woo H2, Gomez Sancha F3, Collins E4, de la Rosette J5, Muir G6, Tabatabaei S7, Choi B8, Reich O9 1 Department of Urology, University Hospital Basel, Basel, Switzerland; 2Department of Urology, Westmead Hospital, The University of Sydney, Sydney, Australia; 3 Institute of Advanced Urological Surgery, Madrid, Spain; 4California Urological Services, San Francisco, USA; 5Department of Urology, Academic Medical Center, University of Amsterdam, The Netherlands; 6Department of Urology,
UROLOGY 74 (Supplment 4A), October 2009