Comparison of 2-μm Continuous Wave Laser Vaporesection of the Prostate and Transurethral Resection of the Prostate: A Prospective Nonrandomized Trial With 1-year Follow-up

Objectives

To compare the safety and efficacy of the 2-μm continuous wave (cw) laser vaporesection of the prostate with transurethral resection of prostate (TURP) in patients with symptomatic benign prostatic hyperplasia (BPH).

Methods

In this prospective study, 100 patients with a prostate weight of < 80 g underwent 2-μm cw laser vaporesection (n = 58) or TURP (n = 42). Efficacy follow-up included measurement of International Prostate Symptom Score, quality of life score, maximal urinary flow rate, and postvoid residual volume. Peri- and postoperative complications were also compared.

Results

The mean operative time was slightly longer in the 2-μm laser group, 54.2 ± 20.8 minutes, than the TURP group 42.0 ± 10.5 minutes (P <.05). No blood transfusion was needed in the 2-μm laser group. Catheter indwelling time 1.8 ± 0.3 days vs 3.4 ± 1.9 days, and hospitalization time 3.2 ± 1.6 days vs 6.5 ± 2.4 day were shorter in 2-μm laser group than in TURP group (P <.05). Within the 12-month follow-up, the mean International Prostate Symptom Score improved by 85.4% in the laser group and 81.1% in the TURP group. Mean maximal urinary flow rate_. increased 229.2% for the laser group and with a similar increase of 218% for the TURP group (P >.05); however, perioperative morbidity was less in the 2-μm laser group.

Conclusions

The 2-μm cw laser vaporesection is a novel technology with favorable perioperative safety as well as the same therapeutic effect as TURP, and has the advantage of significantly less blood loss, shorter hospitalization, and shorter catheter indwelling time.