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Die 80-Watt-Kalium-Titanyl-Phosphat- (KTP-)Laservaporisation der Prostata

Technik und 6-Monatsergebnisse nach 70 Eingriffen

Vaporization of the prostate with the 80 W potassium titanyl phosphate (KTP) laser

Technique and 6 months follow-up after 70 procedures

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Zusammenfassung

Hintergrund

Um die perioperative Morbidität der transurethralen Prostatektomie (TURP) zu reduzieren, wurden in den letzten Jahren verschiedene operative Alternativen erprobt. Wir berichten über unsere ersten Erfahrungen mit der 80-W-Kalium-Titanyl-Phosphat- (KTP-)Laserprostatektomie.

Patienten und Methode

Von September 2002 bis Mai 2003 wurden 70 Patienten, mittleres Alter 70,5 Jahre (46–93 Jahre), mit benigner Prostatahyperplasie (BPH) operiert. Das mittlere transrektale Prostatavolumen betrug 48,1 ml (10–250 ml).

Ergebnisse

Die mittlere Operationszeit für eine 26 ml große Prostata (n=22) betrug 41 min, für eine 46 ml große Prostata (n=33) 64 min und für eine 91 ml große Prostata (n=15) 80 min. Die durchschnittliche maximale Harnflussrate erhöhte sich bereits am Tag der Entlassung um 75,4%, nach 1 Monat um 166,8% und nach 6 Monaten um 168,6% gegenüber der präoperativen Messung.

Schlussfolgerung

Die 80-W-KTP-Laservaporisation der Prostata stellt ein neues Prostatektomieverfahren dar, das infolge der Kombination von ablativen und hämostyptischen Eigenschaften (532 nm) sehr gut zur Behandlung der BPH geeignet ist.

Abstract

Background

Despite good efficacy, even in our days, TURP remains a potentially difficult procedure to perform and is associated with significant risks for the patient. Several alternatives have been tried to reduce the known perioperative morbidity. We report our first experiences with 80 W potassium titanyl phosphate (KTP) laser vaporization of the prostate in patients with symptomatic BPH.

Patients and methods

In 70 patients 80 W KTP laser vaporization was performed successfully. Mean age was 70.5 years (46–93 years) and mean transrectal prostate volume was 48.1 ml (10–250 ml).

Results

Mean operating time was 41 min (n=22), 64 min (n=33), and 80 min (n=15) for a 26 ml, 46 ml, and a 91 ml prostate, respectively. At time of discharge, after 1 month, and 6 months the urinary peak flow increased by 75.4%, 166.8%, and 168.6%, respectively.

Conclusion

The 80 W KTP laser vaporization of the prostate combines the tissue-debulking properties of transurethral resection of the prostate with the known good hemostatic properties of other laser procedures. It is a safe procedure for the patient and provides a virtually bloodless operation and immediate improvement of voiding.

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Danksagung

Wir danken Herrn Dr. Philipp Went (Institut für Pathologie, Universität Basel) für die Anfertigung der makroskopischen Aufnahmen der Prostataresektate.

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Authors and Affiliations

  1. Urologische Klinik, Universität Basel

    A. Bachmann, St. Wyler, R. Ruszat, R. Casella, T. Gasser & T. Sulser

  2. Urologische Klinik, Ludwig Maximilians Universität München

    O. Reich & A. Hofstetter

  3. Urologische Klinik, Universität Basel, Spitalstr. 21, 4031, Basel

    A. Bachmann

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  1. A. Bachmann
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  2. O. Reich
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  3. St. Wyler
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  4. R. Ruszat
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  6. T. Gasser
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  7. A. Hofstetter
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  8. T. Sulser
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Correspondence to A. Bachmann.

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Bachmann, A., Reich, O., Wyler, S. et al. Die 80-Watt-Kalium-Titanyl-Phosphat- (KTP-)Laservaporisation der Prostata. Urologe [A] 43, 1262–1270 (2004). https://doi.org/10.1007/s00120-004-0622-6

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  • DOI: https://doi.org/10.1007/s00120-004-0622-6

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