Impact of Prostate Volume on the Efficacy of High-Power Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate: A Retrospective, Short-Term Follow-Up Study on Evaluating Feasibility and Safety

Abstract

Purpose: We determined the impact of prostate volume on the efficacy of the high-power (80 W) potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate in men with lower urinary tract symptoms (LUTS). Materials and Methods: Patients were stratified into 3 groups according to prostate volume: `<40 g` (n = 49) and `40-59 g` (n = 49) and 60 g` (n = 22). Median follow-up was 9 months (range 6 to 21). Results: No differences in age and follow-up duration were observed in the three groups. At baseline, no significant differences were noted in the three groups in terms of the International Prostate Symptom Score (IPSS) (21.4, 19.4 and 19.1; p = 0.412) as well as the maximum flow rate (Qmax) (10.2, 9.2, and 8.6 mL/s; p = 0.291) and post-void residual (PVR) (66.2, 80.4, and 71.5 mL; p = 0.856). The mean operative times were 30.9, 46.9, and 58.6 minutes (p < 0.001) and total median energy deliveries for each group were 62.3, 97.6, and 135.9 kJ, respectively (p < 0.001). No severe intraoperative complication was observed. At the last follow-up, these parameters improved significantly regardless of prostate volume, and the IPSS (11.1, 9.4, and 12.3; p = 0.286) as well as Qmax (15.9, 15.9, and 14.2 mL/s; p = 0.690) and PVR (33.7, 28.4, and 14.2 mL; p = 0.395) were not significantly different among the groups. Conclusion: Although a larger prostate requires more time and energy delivery, photoselective laser vaporization of the prostate is safe and efficacious for patients with LUTS regardless of prostate volume.