Diode 980 nm Laser Vaporesection of the Prostate: A Comparison of 150 to 250 Watt

Abstract

Objective: The aim of this study is to compare the efficacy and morbidity of the diode 980 nm laser at two different power settings for vaporesection of the prostate. Materials and Methods: A retrospective evaluation of patients who were operated for benign prostatic enlargement by the same surgeon at two different laser power settings. A hundred thirty six patients included in the study were consecutively randomized into 2 groups by certain time periods. The first group consisted of 57 patients with benign prostatic hyperplasia who were treated with 150 Watt and the remaining 79 treated with 250 Watt. International Prostate Symptom Score (IPSS), IPSS-quality of life (QoL), prostate volume, postvoid residual urine, maximum flow rate (Qmax) and prostate specific antigen (PSA) levels were recorded preoperatively and at 3 and 12 months postoperatively. Total energy consumption, lasing times and complications were noted. Results: IPSS, Qmax and IPSS-QoL improved significantly in both groups in accordance with the decrease in prostate volume, postvoid residual and PSA levels. IPSS, Qmax improvement and prostate volume reduction were greater in the second group at the 12th month. Early postoperative irritative symptoms such as dysuria and urge incontinence were significantly more common in the first group (p<0.05). Infravesical obstruction due to necrotic prostate tissue, which required secondary intervention, solely occurred in 5 patients of the second group. Conclusion: Both power settings provided adequate patient satisfaction and significant improvements in objective outcome parameters in the long term, however, high power settings would be preferred for bigger glands for greater volume reduction.

Keywords

• Diode laser
• Prostatectomy
• Vaporisation
• Vaporesection
• Prostate
• Benign prostate hyperplasia
• Infravesical obstruction