The University of Tennessee experience with the Indigo 830e laser device for the minimally invasive treatment of benign prostatic hyperplasia: interim analysis |
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Authors: | Mark Greenberger Mitchell S Steiner |
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Institution: | (1) Department of Urology, University of Tennessee, Memphis, 956 Court Avenue, H-220, Memphis, TN 38163, USA Tel.: +1-901-448-1492, Fax: +1-901-448-4743, US |
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Abstract: | Benign prostatic hyperplasia (BPH) is the most common benign tumor in men and is responsible for urinary symptoms in the
majority of men older than 50 years of age. Although transurethral resection of the prostate (TURP) is the gold standard,
its complications have impacted upon its utility. As a consequence, new pharmacologic and minimally invasive approaches to
the management of BPH have been developed. One minimally invasive approach that employs interstitial laser coagulation by
the Indigo 830e LaserOptic system heats the prostate to the point of irreversible necrosis while preserving the urethral lining,
potentially resulting in fewer complications. To test the efficacy of this device we evaluated the interim results obtained
in 25 patients treated for BPH. Parameters evaluated included the AUA symptom score, uroflowometry, post-void residual, and
prostate size. Following treatment, patients were discharged home and the catheter was removed within 3–7 days. Patients were
assessed at 1 month and at subsequent 3-month intervals following the procedure using a questionnaire, AUA symptom score,
and uroflowometry. The results of the paired t-tests demonstrated a significant increase in the maximal and average flow rates from baseline. The mean baseline maximal
flow rate was 8.3 ml/s and increased to 10, 12.7, 14.1, and 12.0 ml/s at 1, 3, 6, and 9 months, respectively, and the mean
baseline average flow rate was 4.4 ml/s and increased to 5.3, 6.0, 6.6, and 6.2 ml/s at 1, 3, 6, and 9 months, respectively.
The AUA symptom scores decreased from 20.2 to 9.8 at 9 months. There was no intraoperative complication. Six patients developed
transient retention. No patient developed bladder neck contractures, urinary incontinence, impotence, or urinary tract infections.
One patient developed retrograde ejaculation and one patient required retreatment by TURP. Hence, improvements in symptom
scores and voiding parameters suggest that the laser interstitial coagulation prostatectomy is safe and effective for the
treatment of BPH. |
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