Comparative Analysis of the Efficacy and Safety of Photoselective Vaporization of the Prostate for Treatment of Benign Prostatic Hyperplasia according to Prostate Size

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of photoselective vaporization of the prostate (PVP) for treatment of benign prostatic hyperplasia (BPH) in men with a prostate volume greater than 60 cc. MATERIALS AND METHODS: The clinical data of 249 men with symptomatic BPH who underwent PVP between January 2006 and June 2008 were retrospectively analyzed. All patients were classified into two groups according to their prostate volume (group A, <60 cc; group B, ≥60 cc). The preoperative evaluation included a digital rectal exam, urinalysis, prostate-specific antigen levels, International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximal flow rate (Qmax), postvoid residual urine volume (PVR), and transrectal ultrasonography. The total operative time, used energy (kJ), urethral Foley catheter indwelling period, and the number of hospital days were recorded afterward. The IPSS, QoL score, Qmax, and PVR were evaluated at 1, 3, 6, and 12 months postoperatively. RESULTS: In both groups, significant improvements in the subjective and objective voiding parameters were achieved and these improvements were sustainable for at least 1 year with minimal complications. During the follow-up period, the PVR in group B significantly increased. Retrograde ejaculation and urethral stricture were the common complications in both groups. There was no significant difference in the incidence rate. CONCLUSIONS: PVP is safe and efficacious, with durable results for men with symptomatic BPH and large prostate volumes.