Office Based Photovaporization of the Prostate for Benign Prostatic Hyperplasia: Outcomes and Patient Satisfaction

We determined the efficacy, safety and tolerability of photovaporization of the prostate in the office setting for benign prostatic hyperplasia.

Between 2009 and 2011, 139 men with moderate to severe benign prostatic hyperplasia based on I-PSS (International Prostate Symptom Score) underwent photovaporization of the prostate using a 980 nm diode laser under local anesthesia. We compared preoperative and postoperative post-void residual urine volume, maximum urine flow and I-PSS/quality of life questionnaire responses. We also evaluated postoperative complications and patient satisfaction survey responses.

An average ± SD of 782.5 ± 811.1 seconds of laser exposure at maximum power (180 W) resulted in a significant change in median post-void residual urine volume (-126 ml or -81.3%), maximum urine flow (4 ml per second or 40.0%) and I-PSS (-19 or -79.2%, each p <0.001). In men with a prostate greater than 70 ml the median change in post-void residual volume was considerably more pronounced at -232.5 ml (-97.9%, p <0.001) while changes in maximum urine flow (3.0 ml per second or 25%, p = 0.027) and I-PSS (-16.5 or -71.7%, p = 0.003) were also significant. The most common complications were vesicular neck contracture in 7% of cases and urinary retention in 6.4%.

Office based photovaporization of the prostate can be a safe, effective and well tolerated approach to benign prostatic hyperplasia in office settings using local anesthesia. We believe that it can become an attractive low cost treatment option for the rapidly expanding population at risk for benign prostatic hyperplasia.