High power potassium-titanyl-phosphate laser vaporization prostatectomy

Purpose: We prospectively studied a cumulative cohort of men with obstructi ve benign prostatic hyperplasia who underwent potassium-titanyl-phosphate ( KTP) laser vaporization prostatectomy to determine the safety and efficacy of this procedure. Materials and Methods: A total of 55 men with symptomatic bladder outlet ob struction due to benign prostatic hyperplasia were treated with a 60 W. KTP laser produced by a prototype Laserscope dagger generator and delivered th rough a side-deflecting fiber with a 22Fr continuous flow cystoscope. Steri le water was used for irrigation. The prostatic lobes were vaporized to wit hin capsular fibers. Mean lasing time plus or minus standard deviation was 44 +/- 19 minutes. Results: Mean prostate volume plus or minus standard deviation was 43 +/- 1 4 ml. No patient had any significant blood loss or fluid absorption, or req uired blood transfusion. Foley catheters did not require irrigation and wer e removed less than 24 hours postoperatively. All patients remained satisfi ed with voiding outcome, which changed significantly (p <0.0001). Mean impr ovement in American Urological Association symptom score at 3, 6, 12 and 24 -month intervals was 75%, 79%, 82% and 82%, respectively Mean increase in p eak flow rate at the same intervals was 250%, 242%, 255% and 278%, respecti vely. Complications included mild transient dysuria in 7%, bladder neck con tracture in 2% and delayed hematuria in 4% of patients. None of the patient s required re-catheterization or reoperation, or had incontinence or newly developed impotence. Of the sexually active patients 15% and 9% had retrogr ade ejaculation at 1 and 2 years, respectively. Conclusions: Our observation in a 2-year period indicates that 60 W. KTP la ser vaporization prostatectomy is safe and effective for quickly relieving bladder outlet obstruction with minimal postoperative complications, a high rate of patient satisfaction and, to date, a generally good outcome.