HIGH-POWER POTASSIUM-TITANYL-PHOSPHATE (KTP 532) LASER VAPORIZATION PROSTATECTOMY - 24 HOURS LATER/

Objectives. To study the feasibility and immediate postoperative outco me of vaporization prostatectomy by high-power potassium-titanyl-phosp hate (KTP/532) laser in 10 men with bladder outlet obstruction due to benign prostatic hyperplasia (BPH) and to evaluate their clinical and voiding outcome 24 hours postoperatively. Methods. The KTP/532 laser a t 60 W was produced by a prototype Laserscope generator and delivered through a side-deflecting fiber with a 22F continuous-flow cystoscope. Sterile water was used for irrigation. The prostatic lobes were readi ly vaporized to within capsular fibers. The mean lasing time was 29 +/ - 8 minutes, during which a mean of 104.6 +/- 30 kJ of energy was deli vered. Results. The prostate volumes ranged from 22 to 60 mL (mean 38. 4 +/- 9.7). None of the 10 patients had any significant blood loss or any fluid absorption. Foley catheters were removed in less than 24 hou rs postoperatively. All patients were satisfied with their voiding out come. The mean peak urine flow rate increased from 8 +/- 1.3 mL/s preo peratively to 19.4 +/- 8.4 mL/s (142%, P = 0.003266) 24 hours postoper atively. Postvoid residual volumes remained essentially unchanged from their preoperative levels, as expected (P = 0.767423). One patient ha d urgency, but none had dysuria, hematuria, or incontinence or require d recatheterization. Three patients have returned for 3-month follow-u p; all 3 patients have had excellent results and are very satisfied wi th the outcome. Conclusions. Our very early and limited experience ind icates that high-power KTP/532 laser vaporization prostatectomy is fea sible and appears to be safe and effective for quickly relieving bladd er outlet obstruction due to BPH. Larger randomized clinical trials to compare this technique with standard transurethral resection of the p rostate and more follow-up data are needed to determine its long-term efficacy and durability. (C) 1998, Elsevier Science Inc. All rights re served.