PURPOSE: To evaluate the efficacy and safety of Green Light Laser Prostatectomy (GLLP) in high risk patients with urinary retention(UR) secondary to benign prostate hyperplasia.
MATERIALS-METHODS: Forty-six male patients with mean age of 73.78 ± 9.82 years who underwent GLLP due to UR between January 2015 and June 2017 were included. GLLP was done by one urologist. Six patients (13%) had history of previous standard transurethral resection of prostate (TURP) and 7 (15.2%) had neurogenic bladder. The majority of patients (42 patients, 91.3%) had at least 2 comorbid diseases: cardiac vascular with anticoagulant therapy, pacemaker, diabetes and hypertension. We evaluated perioperative parameters including: serum PSA value, prostate volume, period of post-operative catheterization, vaporization time, delivered energy, hospitalization period, as well as intraoperative and postoperative complications. In the follow up protocols: International Prostate Symptom Score and quality-of-life questionnaire (IPPS-QoL), post void residual volume (PRV), and incontinence were also assessed. The mean follow-up period was 15.57 ± 9.26 (1-42) months.
RESULTS: All patient get rid of UR, except 1 patient ( 2.1%) remained on Foley catheter and standard TURP was done for the patient. Mean vaporization time was 8.57 ± 4.19 (4–22) min, and mean energy delivered was 51.7 ± 29.9 (17.0–117.0) kJ. No intraoperative complications were observed. No blood transfusion was done. Mean catheterization and hospitalization periods times were 7.77 ± 5.34 (1–30) and 1.41 ± 0.86 (1–5) d, respectively. The mean postoperative IPSS at the last follow up was 9.64 ± 6.65 and the QoL score was 1.61 ± 1.31. PVR was insignificant ( less than 50 cc) Urethral strictures were observed in only one (2.2%) patient, urinary incontinence was seen in 11 (23.9%) patients and retrograde ejaculation in only one (2.2%) patient. 
CONCLUSION: GLLP is a safe, simple and effective procedure for the treatment of UR secondary to BPH in high risky patients. Short hospitalization, low rate of intra operative and postoperative complication with rapid improvements in the objective and subjective voiding parameters are important consideration of this procedure. Our observation suggests that significant improvement in outcomes are durable.
 

Conference Title

The 26th National Urology Congress

Conference Country

Turkey

Conference Date

Jan. 1, 2017 - Jan. 1, 2017

Conference Sponsor

Turkish Journal of Urology