OCTOGENARIANS WITH SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH) HAVE SIMILAR OUTCOMES AFTER...
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Vol. 179, No. 4, Supplement, Wednesday, May 21, 2008 THE JOURNAL OF UROLOGY ® 631 obstruction symptoms were 6 months to 10 years (average 5 years). Sixty-eight BPH patients also had blood hypertension and 56 patients have diabetes. IIEF-5 was investigated before the operation. All patients with epidural anesthesia and were followed up for 3 to 20 months. Urinary symptoms and IIEF-5 score were evaluated. RESULTS: Among 360 patients, 120 patients had sexual activity once two weeks or once a month before the operation. These 120 patients were all followed up. After the operation, the voiding symptoms were improved apparently in 112 patients (112/120, 93.33%).Three months after the operation, 100 patients (83.34%) had erectile phenomenon in the morning. Eighty-six patients (71.67%) had patients (81.67%) had satisfactory sexual activity, 8 had no sexual activity and 26 suffered from retrograde ejaculation after PVP. CONCLUSIONS: PVP is an effective and minimally invasive BPH patients with ED after PVP is related to other basic diseases (such as blood hypertension and diabetes), conjugal condition, psychological demand and the age of the patient. In conclusion, PVP is a safe and effective treatment method for BPH with fewer complications such as dysfunction of sexual activity. Source of Funding: None 1839 INTERNATIONAL MULTICENTER EXPERIENCE OF THE GREENLIGHT HPS 120W LASER IN PATIENTS WITH BENIGN PROSTATIC OBSTRUCTION, IN URINARY RETENTION, ON ANTICOAGULANTS AND WITH LARGE PROSTATES Henry H Woo*, Oliver M Reich, Jean de la Rosette, Edward J Collins, Alexander Bachmann, Ben Choi, Gordon H Muir, Fernando Gomez Sancha, Shahin Tabatabaei. Sydney, Australia, Munich, Germany, Amsterdam, The Netherlands, San Francisco, CA, Basel, Switzerland, New York, NY, London, United Kingdom, Madrid, Spain, and Boston, MA. INTRODUCTION AND OBJECTIVE: Photoselective vaporisation of the prostate has a sound theoretical basis for allowing in clinical settings where conventional surgery may be challenging. The laser for treating BPO in the setting of urinary retention, anticoagulation METHODS: A pooled database was generated of 305 patients treated with the GreenLight HPS 120 W laser since July 2006 by the International GreenLight Laser User’s Group (IGLU). International residual urine (PVR) and prostate volume were compared at baseline and 3 months follow-up in patients in retention, with concomitant RESULTS: Changes in all parameters were significant compared with baseline (P > 0.001). For patients in retention (n = 63), the percentage change in IPSS, PVR and prostate volume was -73.2%, -93.9% and -46.0% compared with -63.0%, -77.7% and -45.9%, respectively for patients not in retention. The change between groups (n = 70), the percentage change in IPSS, Qmax, PVR and prostate volume was -62.4%, +128.0%, -78.5% and -50.8% compared with -64.7%, +214.3%, -88.0% and -44.2%, respectively, for patients not on IPSS, Qmax, PVR and prostate volume were -63.6%, +233.3%, -86.4% and -52.5% compared with -64.2%, +185.5%, -85.9% and -42.3%, rate of complications was low in all groups. CONCLUSIONS: The GreenLight HPS 120 W laser is a for those men in urinary retention, on anticoagulant therapy or with Source of Funding: None 1840 OCTOGENARIANS WITH SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH) HAVE SIMILAR OUTCOMES AFTER PHOTOSELECTIVE LASER VAPORIZATION OF THE PROSTATE (PVP) COMPARED TO A YOUNGER COHORT DESPITE INCREASED COMORBIDITIES Ricardo R Gonzalez*, Samit D Soni, Balaji Reddy, Mazumdar Madhu, Steven A Kaplan, Alexis E Te. Houston, TX, and New York, NY. INTRODUCTION AND OBJECTIVE: BPH incidence increases clinical series. The purpose of this study was to determine the safety younger men. <80, with symptomatic BPH had PVP with an 80 W potassium-titanyl- prostate volume (PV), Charlson Index (CI) and International Prostate Symptom Score (IPSS). IPSS, Qmax, PVR and medication usage to evaluate these parameters after PVP over time. than the younger cohort (CI 1.27 vs. 0.70, p<0.01), but no intergroup preoperative differences were noted in PSA, prostate volume, or bladder capacity. Older men trended towards higher incidence of combination medical therapy (CMT) with an alpha blockers (AB) and 5-alpha reductase inhibitors (5ARI) (51% vs. 38%), catheter-dependent urinary retention (57% vs. 32%), and impaired detrusor contractility (IDC) (24% decreased, and Qmax increased as is seen in Figure 1. PVR for elder men decreased by an average of 113.2 mL (p<0.01) and by 165.4 mL for men <80 (p<0.01) without differences between groups (p=0.12). both cohorts, such as acute urinary retention (AUR) or reoperation, when controlled for IDC. CONCLUSIONS: PVP is a safe and effective treatment for urinary symptoms, retention, and reducing BPH medication use in octogenarians despite the presence increased comorbidities. Our results demonstrate that PVP improves subjective and objective parameters in men regardless of age without increased risk of AUR or reoperation. Source of Funding: None
Transcript of OCTOGENARIANS WITH SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH) HAVE SIMILAR OUTCOMES AFTER...
Vol. 179, No. 4, Supplement, Wednesday, May 21, 2008 THE JOURNAL OF UROLOGY® 631
obstruction symptoms were 6 months to 10 years (average 5 years). Sixty-eight BPH patients also had blood hypertension and 56 patients have diabetes. IIEF-5 was investigated before the operation. All patients
with epidural anesthesia and were followed up for 3 to 20 months. Urinary symptoms and IIEF-5 score were evaluated.
RESULTS: Among 360 patients, 120 patients had sexual activity once two weeks or once a month before the operation. These 120 patients were all followed up. After the operation, the voiding symptoms were improved apparently in 112 patients (112/120, 93.33%).Three months after the operation, 100 patients (83.34%) had erectile phenomenon in the morning. Eighty-six patients (71.67%) had
patients (81.67%) had satisfactory sexual activity, 8 had no sexual activity and 26 suffered from retrograde ejaculation after PVP.
CONCLUSIONS: PVP is an effective and minimally invasive
BPH patients with ED after PVP is related to other basic diseases (such as blood hypertension and diabetes), conjugal condition, psychological demand and the age of the patient. In conclusion, PVP is a safe and effective treatment method for BPH with fewer complications such as dysfunction of sexual activity.
Source of Funding: None
1839INTERNATIONAL MULTICENTER EXPERIENCE OF THE GREENLIGHT HPS 120W LASER IN PATIENTS WITH BENIGN PROSTATIC OBSTRUCTION, IN URINARY RETENTION, ON ANTICOAGULANTS AND WITH LARGE PROSTATESHenry H Woo*, Oliver M Reich, Jean de la Rosette, Edward J Collins, Alexander Bachmann, Ben Choi, Gordon H Muir, Fernando Gomez Sancha, Shahin Tabatabaei. Sydney, Australia, Munich, Germany, Amsterdam, The Netherlands, San Francisco, CA, Basel, Switzerland, New York, NY, London, United Kingdom, Madrid, Spain, and Boston, MA.
INTRODUCTION AND OBJECTIVE: Photoselective vaporisation of the prostate has a sound theoretical basis for allowing
in clinical settings where conventional surgery may be challenging. The
laser for treating BPO in the setting of urinary retention, anticoagulation
METHODS: A pooled database was generated of 305 patients treated with the GreenLight HPS 120 W laser since July 2006 by the International GreenLight Laser User’s Group (IGLU). International
residual urine (PVR) and prostate volume were compared at baseline and 3 months follow-up in patients in retention, with concomitant
RESULTS: Changes in all parameters were significant compared with baseline (P > 0.001). For patients in retention (n = 63), the percentage change in IPSS, PVR and prostate volume was -73.2%, -93.9% and -46.0% compared with -63.0%, -77.7% and -45.9%, respectively for patients not in retention. The change between groups
(n = 70), the percentage change in IPSS, Qmax, PVR and prostate volume was -62.4%, +128.0%, -78.5% and -50.8% compared with -64.7%, +214.3%, -88.0% and -44.2%, respectively, for patients not on
IPSS, Qmax, PVR and prostate volume were -63.6%, +233.3%, -86.4% and -52.5% compared with -64.2%, +185.5%, -85.9% and -42.3%,
rate of complications was low in all groups. CONCLUSIONS: The GreenLight HPS 120 W laser is a
for those men in urinary retention, on anticoagulant therapy or with
Source of Funding: None
1840OCTOGENARIANS WITH SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH) HAVE SIMILAR OUTCOMES AFTER PHOTOSELECTIVE LASER VAPORIZATION OF THE PROSTATE (PVP) COMPARED TO A YOUNGER COHORT DESPITE INCREASED COMORBIDITIESRicardo R Gonzalez*, Samit D Soni, Balaji Reddy, Mazumdar Madhu, Steven A Kaplan, Alexis E Te. Houston, TX, and New York, NY.
INTRODUCTION AND OBJECTIVE: BPH incidence increases
clinical series. The purpose of this study was to determine the safety
younger men.
<80, with symptomatic BPH had PVP with an 80 W potassium-titanyl-
prostate volume (PV), Charlson Index (CI) and International Prostate Symptom Score (IPSS). IPSS, Qmax, PVR and medication usage
to evaluate these parameters after PVP over time.
than the younger cohort (CI 1.27 vs. 0.70, p<0.01), but no intergroup preoperative differences were noted in PSA, prostate volume, or bladder capacity. Older men trended towards higher incidence of combination medical therapy (CMT) with an alpha blockers (AB) and 5-alpha reductase inhibitors (5ARI) (51% vs. 38%), catheter-dependent urinary retention (57% vs. 32%), and impaired detrusor contractility (IDC) (24%
decreased, and Qmax increased as is seen in Figure 1. PVR for elder men decreased by an average of 113.2 mL (p<0.01) and by 165.4 mLfor men <80 (p<0.01) without differences between groups (p=0.12).
both cohorts, such as acute urinary retention (AUR) or reoperation, when controlled for IDC.
CONCLUSIONS: PVP is a safe and effective treatment for urinary symptoms, retention, and reducing BPH medication use in octogenarians despite the presence increased comorbidities. Our results demonstrate that PVP improves subjective and objective parameters in men regardless of age without increased risk of AUR or reoperation.
Source of Funding: None
