The Effects of 5 alpha-Reductase Inhibition on Benign Prostatic Hyperplasia Treated by Photoselective Vaporization Prostatectomy with the 120 Watt GreenLight HPS Laser System

作者：Strom Kurt H; Gu Xiao; Spaliviero Massimiliano; Wong Carson^*

来源：Journal of the American College of Surgeons, 2011, 212(2): 244-250.

DOI：10.1016/j.jamcollsurg.2010.09.029

BACKGROUND: We sought to determine whether the efficacy and efficiency of 120W Green Light HPS (American Medical Systems, Inc) laser photoselective vaporization prostatectomy (PVP) is compromised in patients on chronic 5 alpha-reductase inhibitor (RI) therapy.
STUDY DESIGN: Our Green Light HPS laser PVP experience in patients with and without long-term 5 alpha RI was evaluated. American Urological Association Symptom Score (AUASS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual (PVR) were measured preoperatively and at 1 and 4 weeks and at 3, 6, 12, 18, and 24 months postsurgery. PSA values and transrectal ultrasonography (TRUS) prostate volumes were determined preoperatively and at 3 months postsurgery.
RESULTS: Fifty-seven patients were on either dutasteride or finasteride (5 alpha RI+) and 124 were not (5 alpha RI-). Mean prostate volumes were 67.1 +/- 35.3 mL and 69.2 +/- 41.9 mL (p = 0.646) and mean PSA values were 2.2 +/- 2.4 ng/mL and 2.7 +/- 2.6 ng/ml (p = 0.289), respectively. There were no significant differences in the parameters of laser use (13.6 +/- 9.2 minutes and 13.4 +/- 10.4 minutes, p = 0.965) and energy usage (87.1 +/- 62.4 kJ and 91.8 +/- 69.6 kJ, p = 0.623). The majority of patients were catheter-free at discharge for this wholly outpatient procedure. AUASS, QoL, and Qmax values showed significant improvement within each group (p < 0.05). Compared with baseline, PVR values improved in both groups but did not decrease significantly in 5 alpha RI+ (p > 0.05). There was no significant difference in the degree of improvement between the 2 groups in all parameters (AUASS, QoL, Qmax, PVR, PSA, and TRUS volume).
CONCLUSIONS: The efficacy and efficiency of PVP with the GreenLight HPS laser are not negatively affected in patients on chronic 5 alpha RI therapy. (J Am Coll Surg 2011;212:244-250.

• 出版日期2011-2