Long-term outcomes of laser prostatectomy for storage symptoms: Comparison of serial 5-year follow-up data between 120W HPS photo-selective vaporization of the prostate and holmium laser enucleation of the prostate

To compare long-term outcomes for storage symptoms between PVP-120W-HPS and HoLEP, and to find factors influencing postoperative improvement of storage symptoms in the long term.

A total of 266 men (PVP-120W-HPS group, 165; HoLEP group, 101), for whom 60-month follow-up data were available, were included in our study. Outcomes were assessed serially at 6-, 12- 24-, 36-, 48-, and 60-months postoperatively, using the IPSS, uroflowmetry, and serum PSA level. Postoperative improvement in storage symptoms was defined as a reduction by ≥ 50% of subtotal-storage-symptom-score at each follow-up visit after surgery compared to baseline.

Improvements of frequency, urgency, nocturia, subtotal-storage-symptom-scores, and QOL index were maintained up to 60-months after PVP-120W-HPS or HoLEP. There was no difference in degree of improvement in storage symptoms or percentages of patients with postoperative improvement of storage symptoms between the two groups throughout the long-term follow-up period. However, HoLEP group showed greater improvement in voiding symptoms and QOL than PVP-120W-HPS group. On logistic regression analysis, the higher baseline subtotal-storage-symptom-score and the higher bladder-outlet-obstruction index (BOOI) were the factors influencing the improvement of storage symptoms at 5-years after PVP-120W-HPS or HoLEP.

Our serial follow-up data suggest that improvement of storage symptoms was maintained throughout the long-term postoperative period for both PVP-120W-HPS and HoLEP, without any difference between the two surgeries. Also, more severe storage symptoms at baseline and more severe degree of BOOI are predictors of improvement of storage symptoms in the long-term after PVP-120W-HPS or HoLEP.

The Journal of urology. 2018 Jan 09 [Epub ahead of print]

Min Chul Cho, Won Hoon Song, Juhyun Park, Sung Yong Cho, Hyeon Jeong, Seung-June Oh, Jae-Seung Paick, Hwancheol Son

Department of Urology, Seoul National University Boramae Medical Center, Seoul, Korea., Department of Urology, Seoul National University College of Medicine, Seoul, Korea., Department of Urology, Seoul National University Boramae Medical Center, Seoul, Korea, and Department of Urology, Seoul National University College of Medicine, Seoul, Korea., Department of Urology, Seoul National University Boramae Medical Center, Seoul, Korea, and Department of Urology, Seoul National University College of Medicine, Seoul, Korea. Electronic address: .

Pelvic Health Weekly Newsletter