Urodynamic Data Underscore Laser Efficacy in BPH
NEW YORK (Reuters Health) Feb 27 – In men with symptomatic benign prostatic hyperplasia (BPH,) urodynamic data from Brazil confirm that a potassium-titanyl phosphate laser achieves the same results as transurethal resection of the prostate (TURP).
Most comparisons have used clinical endpoints or subjective questionnaires rather than urodynamic data.
Dr. João Antonio Pereira-Correia, who led the new study, told Reuters Health by email, “Our medium-term (urodynamic findings) demonstrate — for the first time — the satisfactory performance of both methods in restoring the vesical function, in cases of bladder outlet obstruction, caused by benign prostatic enlargement.”
TURP has been the standard operation when medical therapy fails or side effects are unacceptable. Recently, however, some newer procedures have been successful, including photovaporization of the prostate (PVP) with the GreenLight HPS 120-W laser that was tested in this study. (See Reuters Health story of June 15, 2011.)
Dr. Pereira-Correia and colleagues at Servidores do Estado Hospital, Rio de Janeiro, randomly assigned 20 men with BPH and medium to severe refractory lower urinary tract symptoms (LUTS) to undergo TURP or PVP.
The men did not know which treatment they received. Repeatedly over 24 months after surgery, they returned for evaluation by two urologists and a neuro-urologist; these three doctors were also unaware of patients’ study assignments.
International Prostate Symptom Scores were reduced to a similar extent in both groups, the authors reported online January 18 in BJU International.
There was no significant change in International Index of Erectile Function-5 scores. Half of the PVP group reported urinary urgency and incontinence, but these symptoms resolved spontaneously with a year.
Both groups had improvements in infravesical obstruction, with a significant reduction of at least 20 cm H2O in mean micturition pressure.
“Although very well designed, our study was performed with a small number of patients. We have no doubt that further studies on this topic are needed,” Dr. Pereira-Correia said.
In that vein, he and his colleagues wrote, “We hope that our findings will encourage further detailed analyses of long-term vesical function related to prostatic photovaporization.”
The GreenLight laser is manufactured by American Medical System Inc.
None of the authors reported any conflicts of interest.
BJU Int 2011.