Outcomes of 80 W KTP laser vaporization of the large prostate

We evaluated the safety and efficacy of 80 W potassium-titanyl-phosphate (KTP) laser vaporization of the prostate in men with prostate volumes >70 ml.

Laser vaporization of the prostate with an 80 W KTP laser was applied between September 2003 and April 2005. Preoperative evaluation of 100 patients included the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q(max)), postvoid residual urine volume (PVR), prostate volume, serum sodium, creatinine, hemoglobin, prostate-specific antigen and urinalysis.

The mean age of the patients, mean volume of the prostates, mean operative time and mean energy delivery were 67.0 +/- 7.9 (53-90) years, 98.2 +/- 18.9 (74-170) ml, 150.1 +/- 22.7 (100-240) min and 246.1 +/- 77.8 (100-500) kJ, respectively. The serum sodium, creatinine and hemoglobin levels did not change significantly. Urinary retention requiring recatheterization was detected in 10 patients. There was moderate dysuria in 22 patients with a mean duration of 2 months and mild hematuria in 16 patients with a mean duration of 1 month postoperatively. Urinary tract infection occurred in 5 patients. We observed clot retention in 2 patients. The IPSS, Q(max) and PVR values had significantly improved by postoperative months 1, 3, 6 and 12. Reoperation was performed in 5 patients. Internal urethrotomy was performed in 1 patient with bladder neck contracture.

80 W KTP laser vaporization is a virtually bloodless, safe and effective procedure for surgical treatment of large volume prostates.