Modified vaporization-resection for photoselective vaporization of the prostate using a GreenLight high-performance system 120-W Laser: the Seoul technique.

摘要

OBJECTIVES: The most popular technique of photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) involves vaporization only. We developed a modified vaporization-resection technique that consists of vaporizing a prostate along outlined margins and retrieving the wedge-shaped prostate tissue. We report the operative procedure and clinical outcomes of our technique with the GreenLight high performance system (HPS). METHODS: A total of 104 patients with a prostate volume greater than 40 mL who underwent PVP were included in this retrospective study. Forty patients were treated with the vaporization-only technique (Group non-S) and 64 patients with the Seoul technique (group S). The clinical outcomes were assessed at 1, 3, 6, and 12 months postoperatively using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum flow rate (Q(max.)), and postvoid residual urine volume (PVR). RESULTS: The Q(max.), PVR, IPSS, and QoL scores improved significantly from 1 to 12 months after the PVP compared with the baseline in both groups (P <.05). In the S group, the volume reduction of the prostate per operative time, lasing time, and laser energy were significantly smaller than in the non-S group (P <.05). In general, the overall complication rates were low in the 2 groups. Two patients were found to have prostate cancer on pathology. CONCLUSIONS: The Seoul technique for PVP showed good short-term efficacy and safety for the treatment of BPH. With this technique, we can conserve on the operative time, lasing time, and energy, and obtain prostatic tissue for pathologic evaluation.