IP Journal of Urology, Nephrology and Hepatology Science

KTP laser photovaporization (PVP) versus standard transurethral resection of prostate (TURP) in the treatment of benign prostatic hyperplasia: A prospective randomized trial with one-year results

Full Text PDF

Article Type : Original Article

Author Details: Mahesh Chandra*,Seema Wasnik,Tapan Sinha,Shailesh Karan

Volume : 2

Issue : 2

Online ISSN : XXXX

Print ISSN : XXXX

Article First Page : 17

Article End Page : 22

Abstract

Objective: To compare the outcome of KTP laser photovaporization of prostate in terms its safety and efficacy in the treatment of BPH.
Materials and Methods: A total of one hundred (n=100) patients of BPH with IPSS ?12, Qmax ?15ml/sec or urinary retention were randomized to undergo either KTP laser photovaporization or TURP after standard urological evaluation. The preoperative and perioperative parameters were measured at admission, 1-week, 1, 3, 6 months and 1 year. Various parameters collected include IPSS score, operative-time, need of blood transfusion, length of catheterization, Qmax, PVR and quality of life. All late complications were also recorded.
Observation and Results: Both group had comparable demographic profile which includes prostate volume as measured on USG. Mean operative-time was also comparable for different grades of prostate viz. Grade-I (24min), Grade-II (46 vs. 48min) and Grade-III (72 vs. 77min). Preoperatively, both groups had variable severity of LUTS but most patients only had mild LUTS at 12-month after procedure. After each procedures, the quality of life (QoL) significantly improved in the both groups, the baseline Qmax improved from 6.44.ml/sec to 15.95 in PVP group vs. 5.39ml/sec to 16.07ml/sec in TURP at 1-month after procedure. Foley’s catheter was removed at day-1 and day-3 in TURP and PVP group, respectively. Only one patient required prolonged catheterization in PVP group because of persistent haematuria. Although, the variable amounts of PVR was noted in TURP group but none had PVR>500ml after ablation of equal volume of prostatic tissue in both groups. In the PVP group, no patient required blood transfusion (BT), despite the patients being on oral anticoagulants, whereas in TURP group, 06 patients required BT. Both groups had complications e.g. dysuria, retention, incontinence and retrograde ejaculation but more frequent in PVP group.
Conclusion: KTP laser PVP is almost a bloodless procedure with almost similar outcomes to standard transurethral resection of BPH. Although, PVP is slightly more time-consuming procedure and persistent dysuria for longer time period but the length of catheterization and hospital stay are relatively shorter. Further, the patients in PVP group do not require blood transfusion despite they being on anticoagulant drugs. Therefore, it may be concluded that PVP is safe and efficacious procedure even in the high-risk BPH patients.

Keywords: KTP, BPH, PVP, TURP, Risk, Complications.

Doi No:-10.18231