Comparison of 2-microm continuous wave laser vaporesection of the prostate and transurethral resection of the prostate: a prospective nonrandomized trial with 1-year follow-up.

摘要

OBJECTIVES: To compare the safety and efficacy of the 2-microm continuous wave (cw) laser vaporesection of the prostate with transurethral resection of prostate (TURP) in patients with symptomatic benign prostatic hyperplasia (BPH). METHODS: In this prospective study, 100 patients with a prostate weight of < 80 g underwent 2-microm cw laser vaporesection (n = 58) or TURP (n = 42). Efficacy follow-up included measurement of International Prostate Symptom Score, quality of life score, maximal urinary flow rate, and postvoid residual volume. Peri- and postoperative complications were also compared. RESULTS: The mean operative time was slightly longer in the 2-microm laser group, 54.2 +/- 20.8 minutes, than the TURP group 42.0 +/- 10.5 minutes (P <.05). No blood transfusion was needed in the 2-microm laser group. Catheter indwelling time 1.8 +/- 0.3 days vs 3.4 +/- 1.9 days, and hospitalization time 3.2 +/- 1.6 days vs 6.5 +/- 2.4 day were shorter in 2-microm laser group than in TURP group (P <.05). Within the 12-month follow-up, the mean International Prostate Symptom Score improved by 85.4% in the laser group and 81.1% in the TURP group. Mean maximal urinary flow rate increased 229.2% for the laser group and with a similar increase of 218% for the TURP group (P >.05); however, perioperative morbidity was less in the 2-microm laser group. CONCLUSIONS: The 2-microm cw laser vaporesection is a novel technology with favorable perioperative safety as well as the same therapeutic effect as TURP, and has the advantage of significantly less blood loss, shorter hospitalization, and shorter catheter indwelling time.