Diode Laser (980 nm) vaporization in comparison with transurethral resection of the prostate for benign prostatic hyperplasia: Randomized clinical trial with 2-year follow-up

摘要

Purpose To compare outcomes of diode laser vaporization of prostate with transurethral resection of the prostate (TURP) as a gold-standard treatment. Materials and Methods A total number of 115 patients with benign prostatic hyperplasia underwent TURP and 980-nm diode vaporization of prostate in a balanced randomization (1:1) from 2010 to 2012 and were followed up for 24 months. Baseline characteristics of the patients, perioperative data, and postoperative outcomes were compared. The primary end point of the study was assessing the values of International Prostate Symptom Score (IPSS), and maximum flow rate (Qmax) to predict the functional improvement of each group. The trial is registered at http://www.irct.ir (number IRCT201202138146N3). Result The mean age (± standard deviation) of the patients was 68.2 ± 7.8 years in TURP and 68.5 ± 8.8 in diode groups. In TURP and diode groups, the operation time was 54.9 ± 15.3 vs 60.6 ± 22.6 minutes (P =.14), Foley catheterization time was 88.9 ± 22.5 vs 20.1 ± 4.6 hours (P =.0001) and postoperative hospital stay was 59.9 ± 14.4 vs 25.8 ± 9.2 hours (P =.0001) respectively. Outcome with regard to increase in Qmax, decrease in IPSS, and decrease in postvoid residual urine volume showed a dramatic improvement in both groups during the first 6 months. In the TURP group, the values of IPSS and Qmax were respectively lower and higher than diode patients at 12 and 24 months of follow-up. Conclusion According to our study, diode laser vaporization (980 nm) offers a safe and feasible procedure in the management of patients with symptomatic benign prostatic hypertrophy; however, at longer follow-up the functional outcome of diode laser vaporization has been less efficient than TURP.