Prostate laser vaporization in men with urinary retention.

Abstract

OBJECTIVE:

• To evaluate the safety and efficacy of laser vaporization of the prostate (LVP) with several different wavelengths for urinary retention.

PATIENTS AND METHODS:

• A cohort study of patients undergoing LVP from 2005 to 2009 at a single institution was performed. • Outcomes were compared in those patients with urinary retention versus those without, using t-tests, Mann-Whitney U-test, chi-squared test and Fisher's exact test as appropriate.

RESULTS:

• During the study period, 122 patients underwent LVP, of which 39 (32%) presented with refractory urinary retention requiring indwelling or intermittent catheterization. • The mean ± SD period of postoperative follow-up was 11.2 ± 9.6 months. Comparing patients with and without urinary retention, there were no significant preoperative differences in median body mass index (25.6 versus 26.4 kg/m(2) ; P= 0.40) or prostate-specific antigen (2.3 versus 2 ng/mL; P= 0.27). • Patients with urinary retention were significantly more likely to be diabetic (33% versus 12%; P= 0.01), have heart disease (36% versus 15%; P= 0.01) and be taking anticoagulants (61% versus 31%; P= 0.003). • Following LVP, retention patients were more likely than non-retention patients to fail an initial voiding trial (28.2% versus 7.2%; P= 0.002). • In total, 36 of 39 (92%) retention patients no longer required catheterization after postoperative recovery. No patients required perioperative transfusion. • Compared to those without preoperative retention, retention patients had a longer median duration of postoperative catheterization (3 versus 1 days; P= 0.01). • There were similar rates of low- and high-grade complications (P= 0.275 and 1.000, respectively) and no significant difference in median hospital stay (1 versus 0 days; P= 0.212).

CONCLUSIONS:

• In the present study cohort, LVP was an effective and safe therapy for urinary retention. • Compared to patients without retention, those with retention had a higher prevalence of heart disease, diabetes and anticoagulant use. • Because the morbidity of LVP is low, and the prevalence of co-morbid disease high, LVP should be considered for the surgical management of refractory urinary retention.

• Authors: Jeffrey M Woldrich, Kerrin Palazzi-Churas, Charles Lakin, Michael Albo, J Kellogg Parsons
• Journal: BJU international (BJU Int) Vol. 108 Issue 3 Pg. 395-8 (Aug 2011) ISSN: 1464-410X [Electronic] England
• PMID: 21481134 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.

Topics

• Aged
• Aged, 80 and over
• Humans
• Laser Therapy (methods)
• Length of Stay
• Male
• Middle Aged
• Postoperative Complications (etiology)
• Prostatism (surgery)
• Treatment Outcome
• Urinary Catheterization
• Urinary Retention (etiology, surgery)