Abstract
Purpose
To compare serial changes of postoperative storage symptoms between PVP and HoLEP, and to identify the predictors influencing postoperative improvement of storage symptoms.
Methods
A total of 486 men (PVP group: 213 cases; HoLEP group: 273 cases), in whom 12-month follow-up data were available, were included in this retrospective study. Surgical outcomes were evaluated at 1-, 3-, 6-, and 12 months postoperatively using the IPSS, uroflowmetry with post-void residual urine volume (PVR) and serum PSA levels. Improvement of storage symptoms was defined as a reduction by ≥50 % of the subtotal storage symptom score postoperatively compared to baseline.
Results
In both PVP and HoLEP groups, total IPSS, quality-of-life index, frequency score, nocturia score, maximum flow rate and PVR were significantly decreased compared to baseline starting from 1 month after surgery. Whereas urgency score was numerically increased compared to baseline at 1 month after PVP, it was reduced compared to baseline at 1 month after HoLEP. While the subtotal storage symptom score was significantly decreased compared to baseline starting from 3 months after PVP, it was significantly reduced starting from 1 month after HoLEP. On logistic regression analysis, a higher baseline subtotal storage symptom score was the only independent predictor of improvement in storage symptoms after PVP or HoLEP.
Conclusions
Our data suggest that improvement in storage symptoms after HoLEP begins earlier than that after PVP. Also, this study indicates that patients with more severe baseline storage symptoms have a higher likelihood of improvement after PVP or HoLEP compared to those with less severe symptoms.
Similar content being viewed by others
References
Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, Coyne K, Kelleher C, Hampel C, Artibani W, Abrams P (2006) Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 50:1306–1315
Sexton CC, Coyne KS, Kopp ZS, Irwin DE, Milsom I, Aiyer LP, Tubaro A, Chapple CR, Wein AJ, EpiLUTS Team (2009) The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int 103:12–23
Häkkinen JT, Hakama M, Huhtala H, Shiri R, Auvinen A, Tammela TL, Koskimäki J (2007) Impact of LUTS using bother index in Dan-PSS-1 questionnaire. Eur Urol 51:473–478
Mirone V, Imbimbo C, Longo N, Fusco F (2007) The detrusor muscle: an innocent victim of bladder outlet obstruction. Eur Urol 51:57–66
Seki N, Yuki K, Takei M, Yamaguchi A, Naito S (2009) Analysis of the prognostic factors for overactive bladder symptoms following surgical treatment in patients with benign prostatic obstruction. Neurourol Urodyn 28:197–201
Abrams PH (1978) The urodynamic changes following prostatectomy. Urol Int 33:181–186
Naspro R, Bachmann A, Gilling P, Kuntz R, Madersbacher S, Montorsi F, Reich O, Stief C, Vavassori I (2009) A review of the recent evidence (2006–2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate. Eur Urol 55:1345–1357
Bostanci Y, Kazzazi A, Djavan B (2013) Laser prostatectomy: holmium laser enucleation and photoselective laser vaporization of the prostate. Rev Urol 15:1–10
Paick JS, Um JM, Kwak C, Kim SW, Ku JH (2007) Influence of bladder contractility on short-term outcomes of high-power potassium-titanyl-phosphate photoselective vaporization of the prostate. Urology 69:859–863
Cho MC, Park JH, Jeong MS, Yi JS, Ku JH, Oh SJ, Kim SW, Paick JS (2011) Predictor of de novo urinary incontinence following holmium laser enucleation of the prostate. Neurourol Urodyn 30:1343–1349
Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, Speakman MJ, Stief CG (2010) Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol 58:384–397
Al-Ansari A, Younes N, Sampige VP, Al-Rumaihi K, Ghafouri A, Gul T, Shokeir AA (2010) GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia: a randomized clinical trial with midterm follow-up. Eur Urol 58:349–355
Hermanns T, Sulser T, Fatzer M, Baumgartner MK, Rey JM, Sigrist MW, Seifert HH (2009) Laser fibre deterioration and loss of power output during photo-selective 80-w potassium-titanyl-phosphate laser vaporisation of the prostate. Eur Urol 55:679–685
Elmansy H, Baazeem A, Kotb A, Badawy H, Riad E, Emran A, Elhilali M (2012) Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 Ml: preliminary results of a prospective, randomized clinical trial. J Urol 188:216–221
Hakenberg OW, Pinnock CB, Marshall VR (1997) Does evaluation with the International Prostate Symptom Score predict the outcome of transurethral resection of the prostate? J Urol 158:94–99
Doll HA, Black NA, McPherson K (1994) Transurethral resection of the prostate for benign prostatic hypertrophy: factors associated with a successful outcome at 1 year. Br J Urol 73:669–680
Hakenberg OW, Pinnock CB, Marshall VR (2002) Preoperative urodyamic and symptom evaluation of patients undergoing transurethral prostatectomy: analysis of variables relevant for outcome. BJU Int 91:375–379
Flood AB, Black NA, McPherson K, Smith J, Williams G (1992) Assessing symptom improvement after elective prostatectomy for benign prostatic hypertrophy. Arch Intern Med 152:1507–1512
Margel D, Lifshitz D, Brown N, Lask D, Livne PM, Tal R (2007) Predictors of nocturia quality of life before and shortly after prostatectomy. Urology 70:493–497
Housami F, Abrams P (2008) Persistent detrusor overactivity after transurethral resection of the prostate. Curr Urol Rep 9:284–290
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standard
This study was approved by the appropriate Institutional Review Board at our Hospital and complied with the Declaration of Helsinki (revised Edinburgh, 2000).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cho, M.C., Ha, S.B., Oh, SJ. et al. Change in storage symptoms following laser prostatectomy: comparison between photoselective vaporization of the prostate (PVP) and holmium laser enucleation of the prostate (HoLEP). World J Urol 33, 1173–1180 (2015). https://doi.org/10.1007/s00345-014-1424-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-014-1424-0