Laser prostatectomy in high-risk patients

To evaluate the short-term tolerability and outcome of high power green light potassium titanyl phosphate laser prostatectomy in high-risk patients with symptomatic benign prostatic hyperplasia.

Eleven high risk operative patients were included in this study at the International Medical Center, Jeddah, Kingdom of Saudi Arabia, between January and September 2007. Patients enrolled in this study underwent preoperative and postoperative, cardiac and anesthesia evaluation. Clinical presentations, ultrasound of urinary tract, and preoperative laboratory investigation were recorded. All patients underwent high power green light laser prostatectomy using the green light photo vaporization system with setting of 120 watts.

The intraoperative and postoperative complications, and follow up were recorded. The patients' age varied between 65-82 years with a mean age of 75.3+/-8.6 years old. Seven patients presented with refractory acute urinary retention, and 4 patients presented with severe lower urinary tract symptoms. The average prostate volume was 61.2 cc. All patients had uneventful intra- and postoperative course, without any significant complications, except one patient who required postoperative admission to the intensive care. The average blood loss was insignificant, and only one of the patients required blood transfusion. Foley catheters were removed one day after the procedure. All patients voided satisfactorily after removal of the catheter, and 8 patients complained of urgency.

High power green light laser prostatectomy is a safe and effective method of treating symptomatic benign prostatic hyperplasia in patients with high operative risk.