Clinical study on the application of a 2- μ m continuous wave laser in transurethral vaporesection of the prostate

Abstract

The present study aimed to evaluate the method and clinical effects of transurethral dividing vaporesection of the prostate in the management of benign prostatic hyperplasia (BPH) using the RevoIix 70 W 2-μm continuous wave (cw) laser. A total of 155 BPH patients were treated transurethrally under epidural or sacral anesthesia using the dividing vaporesection technique. Of these, 80 had a prostate volume of ≤80 ml and 75 had a prostate volume of >80 ml. Pre- and post-operative data were evaluated for prostate-specific antigens (PSAs), post-void residual volume (PVR), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS) and quality of life (QoL). Statistical analyses were performed using the SPSS 16.0 software. Treatment effectiveness evaluations were also conducted. In the ≤80 ml prostate volume group, the mean PSA level decreased from 3.8±0.9 to 2.6±1.3 ng/ml. The PVR, mean Qmax, IPSS and QoL score improved significantly (P<0.05) in each group but no statistically significant difference was identified between the two groups. With a shorter surgery duration, safe use and high cutting efficiency and rapid vaporization ability, the 2-μm laser vaporesection technique shows superiority compared to standard techniques in the treatment of BPH.

Keywords: 2-μm continuous wave laser; benign prostatic hyperplasia; transurethral resection.

Figure 1

Surgical process of vaporization resection: left, operation video image; right, corresponding animation diagram. (A) Initial incision at 5 o’clock; (B) the left tip blunt dissection process; (C) resecting and segmenting left lobe.

Figure 2

Statistical analysis result of patients with prostate volume over 80 ml. (A) comparison of maximum urinary flow rate before operation and 12-month follow-up. (B) comparison of IPSS and Qol (quality of life) index before operation and 12-month follow-up. ^*P<0.05 compared with value before operation.