Photoselective laser vaporization of the prostate in the treatment of bladder outlet obstruction in advanced-stage prostate cancer: a single-center experience.

Background and Purpose: The study in China is the first on photoselective vaporization of the prostate (PVP) applied to bladder outlet obstruction (BOO) or urinary retention from advanced-stage prostate cancer (PCa). The aim is to evaluate the efficacy and safety of PVP in the treatment of patients with BOO secondary to advanced-stage PCa. Patients and Methods: Forty-five patients (mean age 76.13 +/- 5.88 years, range 62-89 years) with BOO or urinary retention secondary to advanced-stage PCa received PVP with a potassium-titanyl-phosphate laser. The treatment outcome was evaluated with subjective and objective tests at 1, 3, 6, and 12 months after PVP using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, postvoid residual (PVR) urine volume, and maximum urinary flow rate (Qmax). The operative time, indwelling catheterization time, and operative complications were also observed. Results: All 45 patients recovered without incident. The mean operative time was 50 +/- 7.6 minutes. The catheterization duration was 3.2 days (range 2-7 days). There was significant improvement in Qmax from 7.29 +/- 0.93 to 12.16 +/- 2.75 mL/sec after treatment at 12 months. Mean PVR volume decreased from 210.94 +/- 179.49 to 54.45 +/- 33.16 mL. Mean IPSS score decreased from preoperative 28.19 +/- 3.64 to postoperative 14.61 +/- 2.81 (P < 0.05), QoL score decreased from 5.03 +/- 0.69 to 3.66 +/- 0.65 (P < 0.05). There were no intraoperative adverse events. Postoperative complications included mild transient hematuria in 12 (26.7%) patients and mild dysuria in 11 (24.4%) patients within 4 weeks. Conclusions: The clinical results suggest that PVP is a safe, efficient, and less-invasive treatment for patients with BOO or urinary retention secondary to advanced-stage PCa.