Abstract | PURPOSE: MATERIALS AND METHODS: A randomized controlled noninferiority trial comparing holmium laser enucleation of the prostate to photoselective vapo-enucleation of the prostate-XPS 180 W was conducted. I-PSS, flow rate, residual urine, prostate specific antigen and prostate volume changes as well as perioperative and late adverse events were compared. Noninferiority of I-PSS at 1 year was evaluated using a 1-sided test at 5% level of significance. The statistical significance of other comparators was assessed at the (2-sided) 5% level. RESULTS: Overall 50 and 53 patients were included in the holmium laser enucleation and photoselective vapo-enucleation of the prostate groups, respectively. Operative time, hospital stay and time to catheter removal were comparable between the groups. There was significant, comparable improvement in I-PSS and post-void residual urine volume at 1, 4 and 12 months. After 4 months prostate size reduction was significantly higher in the holmium laser enucleation of prostate group (74.3% vs 43.1%, p=0.001). At 12 months maximum urine flow rate was significantly higher in the holmium laser enucleation of prostate group (26.4 ±11.5 vs 18.4 ±7.5 ml per second, p=0.03). Re-intervention was needed in 2 and 3 cases in the holmium laser enucleation and photoselective vapo-enucleation of the prostate groups, respectively (p=1.0). Mean estimated cost per holmium laser enucleation of prostate procedure was significantly lower than per photoselective vapo-enucleation of the prostate procedure. CONCLUSIONS:
|
Authors | Ahmed M Elshal, Mohamed A Elkoushy, Ahmed R El-Nahas, Ahmed M Shoma, Adel Nabeeh, Serge Carrier, Mostafa M Elhilali |
Journal | The Journal of urology
(J Urol)
Vol. 193
Issue 3
Pg. 927-34
(Mar 2015)
ISSN: 1527-3792 [Electronic] United States |
PMID | 25261801
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
|
Copyright | Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
Topics |
- Aged
- Aged, 80 and over
- Humans
- Laser Therapy
- Lasers, Solid-State
(therapeutic use)
- Male
- Middle Aged
- Prospective Studies
- Prostatectomy
(methods)
- Prostatic Hyperplasia
(surgery)
|