Photoselective vaporization of the prostate: subgroup analysis of men with refractory urinary retention.

Abstract

The purpose of this study was to evaluate the feasibility and efficacy of photoselective vaporization of the prostate (PVP) in patients with refractory urinary retention (RUR) secondary to benign prostate hyperplasia (BPH). Perioperative data, postoperative outcomes, and adverse events within 24 months in 70 patients with RUR were compared to 113 men with no urinary retention (NUR) before surgery. Follow-up for the two groups was as follows (RUR vs. NUR at 1, 3, 6, 12, and 24 months): peak urinary flow rate: 16.9 vs. 19.4 ml/s, 16.3 vs. 20.9 ml/s, 17.7 vs. 19.7 ml/s, 18.2 vs. 21 ml/s, and 19.4 vs. 23.3 ml/s; International Prostate Symptom Score: 7.6 vs. 10.7, 7 vs. 7.5, 5.7 vs. 6.2, 5.5 vs. 6.5, and 4.4 vs. 6.5, respectively. Postoperative urinary retention and complication rates were comparable for the two groups. In five patients (2.7%), a reoperation with PVP or transurethral resection of the prostate was necessary. Bladder neck contracture and urethral stricture developed in 0.5% (n=1) and 4.9% (n=9), respectively. PVP seems to be a safe and effective surgical tool in patients with RUR caused by prostatic enlargement. The complication rate is comparable to that of patients with NUR before PVP.