A prospective, single-center, randomized clinical trial to evaluate the efficacy of three types of laser vaporization surgeries using a 180-W GreenLight XPS laser, a 300-W diode laser, and a 200-W thulium laser for the treatment of benign prostatic hyperplasia

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2022-06-19 DOI:10.1111/luts.12453

Tatsunori Okada, Mikifumi Koura, Ryota Sumikawa, Hiroyuki Masaoka, Yoohyun Song, Takashi Dejima, Narihito Seki

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引用次数: 1

Abstract

Objectives

This study aimed to compare the safety and efficacy of three different laser prostate vaporization surgeries, which were photoselective vaporization of the prostate (PVP), diode laser vaporization (DVP), and thulium laser vaporization (ThuVAP), for the treatment of benign prostatic hyperplasia (BPH) in a randomized clinical trial.

Methods

A total of 71 consecutive patients with BPH were included; 23 patients were treated with PVP, 23 with DVP, and 25 with ThuVAP. Patients were evaluated with disease-related symptomatic questionnaires, Quality of Life (QOL) Index, and maximum urinary flow rate (Q_max) for 12 months. Patients were monitored to record operation/vaporization time, 24-hour hemoglobin/sodium drop, length of catheterization/hospitalization, and perioperative/postoperative complications.

Results

In all three groups, patients showed significant and comparable improvements in symptom scores, QOL Index, and Q_max during the 12-month follow-up period. The mean operation/vaporization time was equivalent across all three groups at 69/23 (PVP), 81/34 (DVP), and 76/32 minutes (ThuVAP), while the applied laser energy was lower for PVP at 157 kJ compared to the other two techniques (DVP at 358 kJ, ThuVAP at 240 kJ). The mean vaporization rates per unit energy were significantly different between the three groups (PVP 0.16, DVP 0.09, and ThuVAP 0.09 mL/kJ). There were no significant differences in the main safety profiles between the three groups.

Conclusions

Our study demonstrated that these three types of laser surgeries are similar in terms of complications and outcomes, with excellent hemostasis and high patient satisfaction. It was suggested that sufficient tissue vaporization could be achieved using less energy through PVP surgery.

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一项前瞻性、单中心、随机临床试验，评估三种激光汽化手术使用180w GreenLight XPS激光器、300w二极管激光器和200w铥激光器治疗良性前列腺增生的疗效

目的通过随机临床试验，比较三种不同的激光前列腺汽化手术，即光选择性前列腺汽化(PVP)、二极管激光汽化(DVP)和铥激光汽化(ThuVAP)治疗良性前列腺增生(BPH)的安全性和有效性。方法选取连续71例BPH患者;PVP治疗23例，DVP治疗23例，ThuVAP治疗25例。采用疾病相关症状问卷、生活质量指数(QOL)和12个月最大尿流率(Qmax)对患者进行评估。监测患者手术/汽化时间、24小时血红蛋白/钠浓度下降、置管时间/住院时间、围手术期/术后并发症。结果在12个月的随访期间，三组患者在症状评分、生活质量指数和Qmax方面均有显著改善。三组的平均操作/蒸发时间为69/23 (PVP)， 81/34 (DVP)和76/32 (ThuVAP)，而PVP的激光能量为157 kJ，低于其他两种技术(DVP为358 kJ, ThuVAP为240 kJ)。三组间单位能量平均蒸发速率(PVP 0.16, DVP 0.09, ThuVAP 0.09 mL/kJ)差异显著。三组之间的主要安全性没有显著差异。结论三种激光手术在并发症和结果上相似，止血效果好，患者满意度高。通过PVP手术，可以用较少的能量实现充分的组织汽化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.