MODERATED POSTER SESSIONS
Moderated Poster Session 9
BPO/LUTS
Tuesday, October 18
13:15-14:45
MP-09.01
Hydrodynamic Aspects of Intravesical
Protrusion of the Prostate in Patients
with Voiding Dysfunction
Sakuyama G1, Ishii T1, Yamanishi T2,
Igarashi T1
1
Dept. of Medical System Engineering,
Faculty of Engineering, Chiba University,
Chiba, Japan; 2Dept. of Urology, Dokkyo
Medical University School of Medicine,
Mibu Machi, Japan
Introduction and Objective: Intravesical protrusion of the prostate is known as
potent predictor of voiding dysfunction
(Int J Urol 13: 1509, 2006; J Urol 178(2):
573, 2007). On the other hand, previous
report indicated that urine flows along the
wall of the bladder (Acta Urol Jpn 38:
531, 1992). The present study examined
the hydraulic energy loss through passage
of urine stream through the bladder outlet
using hydrodynamic model of lower urinary tract with intravesical protrusion of
the prostate.
Material and Methods: Three models
for flat, slightly and severely deformed
bladder outlet by protruded prostate were
prepared. CAD software (SolidWorks,
SolidWorks Japan Inc., Tokyo) was used
to depict the three-dimensional models
of the bladder and prostatic urethra, tracing the MRI image of the patients with
BPH. The software was used to test the
hydrodynamic simulation on the models.
The hydraulic energy is calculated using
the following formula: E⫽p/wg⫹(Q/A)2/
2g. (E: hydraulic energy, p: pressure, w:
density of water, g: gravity, Q: flow rate,
A: cross area of flow).
Results: The urine flow is clearly disrupted by protrusion of the prostate in
the bladder outlet (figure 1 B). The hydraulic energy of the urine flow was reduced through passing the bladder outlet
in the slightly protruded model, and is
deteriorated before reaching to the bladder outlet in the severely protruded
model (figure 2).
Conclusions: The study indicated importance of shape of the bladder outlet for
voiding dysfunction. Hydrodynamic model
would be useful to understand the mechanism of voiding dysfunction.
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MP-09.01, Figure 1.
MP-09.01, Figure 2.
MP-09.02
Role of Resistive Index as Prognostic
Indicator in Treatment of BPH
Singh H, Kumar A
Dept. of Surgery, C. S. M. Medical
University, Lucknow, India
Objectives: Currently pressure-flow study
is considered as reference standard for
diagnosing bladder outlet obstruction
(BOO) in benign prostatic hyperplasia
(BPH). However it is invasive, costly and
associated with urinary tract infections. In
BOO due to BPH, intra-prostatic pressure
rises. These pressure changes cause
changes in prostatic blood flow that can
be studied by colour doppler sonography
by calculating Resistive Index (RI). This
study was done to evaluate the RI in cases
of BPH presenting with moderate to se-
vere symptoms and change in its value
after treatment.
Material and Methods: The study was
conducted on 30 newly diagnosed men
with BOO who had not received any
treatment. Parameters noted were IPSS
score, uroflowmetry, measurement of
post-void residual urine and serum PSA.
Transrectal doppler ultrasonography was
done to look for prostate size and RI. Men
with prostate cancer, prostatitis, raised
PSA, diabetes, coronary artery disease and
peripheral vascular disease were excluded. Based on the findings the patients
underwent either medical therapy (alphablocker with dutasteride) (Group 1) or
were subjected to transurethral resection
of prostate (Group 2). The RI was calculated again at 6-weeks and 6-months after
treatment. Pearson’s coefficient of correlation was used for statistical analysis.
UROLOGY 78 (Supplement 3A), September 2011
MODERATED POSTER SESSIONS
Results: The mean age was 58.2 years
(range 50 – 65). There were 22 and 8 patients in Groups 1 and 2 respectively. The
mean pre-treatment IPSS of Groups 1 and
2 were 23.09⫾6.07 and 23.50⫾9.98 and
prostate volumes were 48.90⫾12.42 ml
and 37.75⫾9.5 ml respectively. Post-therapy the IPSS became 19.9⫾6.1 at 6-weeks
and 14.18⫾5.8 at 6-months in Group 1
and 7.0⫾1.15 at 6-weeks and to 4.5⫾1.0
at 6-months in Group 2. In Group 1, RI
reduced from 0.75⫾0.05 to 0.69⫾0.03 at
6-weeks and to 0.62⫾0.04 at 6-months. In
Group 2, the RI reduced from 0.72⫾ 0.06
to 0.59⫾ 0.09 at 6-weeks and to.57⫾0.09
at 6-months.
Conclusion: Resistive index was significantly high in cases of BPH with moderate
to severe symptoms that significantly reduced after treatment. Resistive index
may become a non-invasive index for measuring BOO and can also serve as a prognostic marker. The main drawback of the
study is small number of cases.
MP-09.03
Operative Impacts on Lower Urinary
Tract Symptom of Patients With BPH
and Prostatitis: Comparison of Post
Transurethral Resection State
Noh C, Yu J, Sung L, Chung J
Inje University, Sanggye Paik Hospital,
Seoul, South Korea
Introduction and Objective: Combination of benign prostatic hyperplasia (BPH)
with prostatitis aggravates clinical symptoms of BPH and complicates its treatment. Persistent lower urinary tract symptoms (LUTS) are highly resistant to
conventional medical management. Recent studies have shown that BPH with
prostatitis contributed to poor improvement of LUTS after transurethral resection
of prostate (TURP). We tried to find out
the operative impacts on LUTS of patients
with BPH according to the presence of
prostatitis.
Materials and Methods: Between 2005
and 2010, 116 patients who had treated
by TURP were investigated. International
prostate symptom score (IPSS) was
checked before and after TURP within
1yr. Patients with prostate cancer were
excluded. Group A was defined as patients with BPH without prostatitis, and
group B was patients with prostatitis. The
presence of prostatitis was determined by
pathologic confirmation after TURP.
Results: Pathologically group A had 58
patients, and group B had 58 patients.
Preoperative IPSS was higher in group B
(group A: 20.14⫾5.61 vs. group B:
22.95⫾5.65, P⫽0.001), Especially preoperative irritative symptom score was notably high. (group A: 6.63⫾3.57 vs. group
B: 9.29⫾4.06, P⫽0.015) There were no
statistical differences in average postoperative IPSS. (group A vs. group B:
14.63⫾6.57 vs. 14.12⫾4.91, P⫽0.634)
However, the differences of pre and postoperative IPSS were 5.51 in group A and
8.83 in group B. (P⬍0.001).
Conclusions: When the prostate hyperplasia was combined to inflammation,
LUTS was more aggravated than the patient with BPH without prostatitis. And
the efficacy of TURP in patients with prostatitis is better than patients without prostatitis.
MP-09.04
The Long-Term Benefits of Combined
Therapy of Chronic Non-bacterial
Prostatitis
Bardan R, Cristina B, Botoca M,
Cumpanas A, Secasan C, Bucuras V
Dept. of Urology, Clinical Emergency
Hospital, Timisoara, Romania
Introduction and Objective: While
most studies of chronic prostatitis therapy
concentrate on immediate effects, our
objective was to evaluate the impact of a
combined therapy regimen at three
months after its discontinuation.
Material and Methods: During the time
interval 01 January 2009 – 30 June 2010
we have evaluated a number of 92 male
patients, aged between 30 and 50 years,
which presented to our outpatient Department for low urinary tract symptoms. We
have applied the diagnosis criteria for
prostatitis and 68 patients were diagnosed
with type III chronic non-bacterial prostatitis. They have signed the informed consent and started combined therapy, using
ciprofloxacin (500 mg p.o. bid), nimesulid
(200 mg p.o. bid), and alfuzosin (10 mg
extended-release formulation, p.o., od),
for six weeks. Clinical evaluation was performed at baseline, at therapy end, and at
three months after therapy discontinuation, including (along total serum PSA dosing and digital rectal examination) the
measurement of peak urinary flow rates
(Qmax), post-void residual volume
(PVRV), and the NIH-CPSI and SHIM questionnaires.
Results: At three months after therapy
discontinuation, compared with therapy
end, patients still had a significant average
increase of the Qmax (⫹2.88 ml/s vs.
⫹3.53 ml/s) and decrease of PVRV (⫺15,7
ml vs. ⫺19,2 ml). Regarding the NIH-CPSI
score, the pain component (questions 1 –
UROLOGY 78 (Supplement 3A), September 2011
4) was reduced in average with 4.68
points at therapy end; after three months,
this reduction was of only 1.96 points in
average. The urinary symptoms component (questions 5, 6) was reduced in average with 2.48 points at therapy end and
the beneficial effect still persisted after 3
months, with 2.23 point of average reduction. The same trend was observed for the
quality of life component (questions 7 –
9): it was improved with 3.51 points in
average after therapy and with 2.87 points
after 3 months. Finally, the SHIM score
improvement of 3.15 points in average at
therapy end was maintained after 3
months, with a 2.92 points average improvement, compared with baseline.
Conclusions: Combined therapy of
chronic non-bacterial prostatitis has
proven beneficial effects, even at 3
months after discontinuation.
MP-09.05
Treatment with Once Daily Tadalafil:
Improvement in Symptoms of Benign
Prostate Hyperplasia and Related
Quality of Life for Men with or
Without Erectile Dysfunction
Drasa K1, Tartari F2, Dredha H2, Dani E1,
Katroshi R3
1
Central Polyclinic,Tirana, Albania;
2
Mother Teresa Hospital, Tirana,
Albania; 3Hospital, Durres, Durres,
Albania
Introduction and Objective: Once daily
Tadalafil is currently approved only for
treatment of erectile dysfunction (ED),
including as needed and once daily dosing
options. Here we tested whether baseline
ED history influenced the effects of tadalafil on benign prostatic hyperplasia (BPH),
low urinary tract symptoms (LUTS).
Materials and Methods: Men (n⫽154)
with LUTS secondary to BPH were enrolled in this randomized double blind
controlled study in a 12 week treatment
to placebo or various doses of tadalafil.
They were associated with statistically and
clinically significant improvements compared to placebo in total International
Prostate Symptoms Scores (IPSS) and IPSS
quality of life (QoL) score at all doses and
in BPH impact index (BII) at 2.5, 5,10 and
20 mg. Subgroup analyses were performed using an ANCOVA model with
effects for baseline, treatment, ED history
indicator and ED history/by treatment/
interaction to analyze baseline to endpoint
changes in IPPSS, BII and IPSS QoL (question 8).
Results: There were 71.4 % (n 110 ) of
men who reported history of ED. Tadalafil
S95
MODERATED POSTER SESSIONS
was associated with similar improvements
in total IPSS and BII scores with or without ED history. Comparing men with vs
without ED history, tadalafil had similar
improvements in both IPSS and BII as
identified by non-significant subgroup and
interaction p-values for IPSS (subgroup
interaction p-values for IPSS (subgroup/
interaction p-values/0,353/0.646) and BII
(0.761/0.855). Tadalafil also improved
IPSS QoL scores compared to placebo (No
ED history, placebo: 0.7; tadalafil 2.5, 5,
10, 20 mg: ⫺0.7, ⫺0.9, ⫺0.8, ⫺0.8), (ED
history, placebo: 0.6; tadalafil 2.5, 5, 10,
20 mg: ⫺0.9, ⫺0.9, ⫺1.0, ⫺1.1). Like
IPSS and BI I, improvements in QoL were
not significantly influenced by ED history
(0.09 /0.793). In men with ED history,
changes in IIEF scores were significantly
correlated to changes in IPSS, BII and IPPS
QoL, all p⬍ 0.001.
Conclusion: The results of this study
indicate that tadalafil treatments demonstrated consistent improvements in IPSS
and BII in men with BPH /LUTS, regardless of their baseline ED history. Tadalafil
was also associated with significant improvements in patients’ reported QoL in
both subgroups. In men with ED, improvements in BPH / LUTS were correlated to improvements in erectile function
as well.
MP-09.06
Role of Combined Use of
Ketoconazole and Tamsulosin in the
Management of Acute Urinary
Retention Due to Benign Prostatic
Obstruction
Elbendary M, El-Gamal O, Gaber M,
Taha M
Tanta University Hospital, Tanta, Egypt
Introduction and Objective: Ketoconazole is an imidazole derivative that has
been shown to block testosterone synthesis and can lower testosterone concentration to castrate levels within 48 hours. We
investigated the effect of addition of ketoconazole to tamsulosin in cases of acute
urinary retention (AUR) due to benign
prostatic obstruction.
Materials and Methods: The patients
who presented with AUR for the first time
due to benign prostatic obstruction (BPO)
were included in this study. Patients with
hepatic or renal impairments were excluded. After urethral catheterization, the
selected patients were randomized into 2
groups. The first group (23 patients) received tamsulosin 0.4 mg/day while the
second one (22 patients) was given tamsulosin plus ketoconazole 200 mg three
S96
times daily. The urethral catheter was
kept in place and drugs were maintained
for 7 days. Patients were put on trial without catheter (TWOC) and those who
voided were evaluated with peak flow
rate (PFR) and post-void residual urine
volume (PVRV) assessment with abdominal ultrasound.
Results: The mean age of the patients
was 64.2 ⫾ 6.3 and 66.4 ⫾5.1 years and
the mean prostate size was 65.7 ⫾ 12.5
and 68.5 ⫾ 11.7 cc for the first and the
second groups respectively with no significant difference between both groups.
The received medications were well tolerated by all patients with no reported significant side effects. The first and the second groups had successful TWOC in
43.5% (10/23) and 77.3% (17/22) respectively (p⫽0.03). Among those who had a
successful TWOC, the peak flow rate was
7.3 ⫾ 1.4 versus 8.9 ⫾ 1.2ml/s (p⫽ 0.02)
and the post-void residual urine volume
was 135.6 ⫾ 24.7 versus 114.2 ⫾ 15.8 ml
(p⫽ 0.03) in the tamsulosin and the combined treatment groups respectively.
Conclusion: Ketoconazole can increase
the success rate of trial without catheter
in patients with benign prostatic obstruction.
MP-09.07
New Direction in the Treatment of
Benign Prostate Hyperplasia Using
Adenoprosin: Biologically Active
Entomological Medicine
Ghicavii V1, Tanase A1, Ceban E1,
Dumbraveanu I1, Ciuhrii V2
1
Dept. of Urology, State Medical
University, Chisinau, Moldova; 2Newtone
Trading, Bucharest, Romania
Introduction and Objective: Currently
the absolutely new forms of drugs are developed such as biologically active substances with antiradical and antioxidant
properties obtained from insects’ biomass.
This is a new approach for the development of medicine for BPH treatment. The
active substance from Lymantria dispar
larvae has high stability and specific antioxidant activity, inhibiting the oxidation
of low density lipoproteins and reducing
the NO radicals.
Material and Methods: During 5 years
(2005-2010), 127 patients with BPH were
investigated and observed. Eighty-five of
them (I group: IPSS 16.8 3.98; QOL 3.68
1.10; DRE; TRUS 52.32 6.7 cm3 prevalently of glandular tissue; QMAX 9.2 2.63
ml/s; PSA 4 –10 ng/ml; PVR 53.7 22.4 ml)
were treated conservatively with suppositories Adenoprosin (250 mg daily) during
5 months. The outcomes were compared
with placebo group of 42 patients (II
group: IPSS 18.2 3.7; QOL 3.2 1.0; DRE;
TRUS 51.0 3.8 cm3 prevalently of glandular tissue; PSA 4 – 10 ng/ml; QMAX10.5 3.4
ml/s; PVR 46.5 26.5 ml).
Results: BPH symptoms were already
changed during the treatment. The final
treatment results in the first group were:
IPSS 11.2 2.24; QOL 2.4 0.3; TRUS 49.8
6.8 cm3; QMAX 13.8 2.8 ml/s; PVR 41.5
18.5 ml; and for the placebo group were:
IPSS 16.8 3.2; QOL 3.1 1.2; TRUS 52.2 4.2
cm3; QMAX9.2 3.8; PVR 48.8 20.6 ml. The
average prostate volume did not deviated
essentially from the initial stage in both
groups. In the first group it was decreased
only in 4.8% of patients (from 52.32 ⫾
6.7 cm3 to 49.8 ⫾ 6.8 cm3). In the placebo-group the average volume of prostate
was increased in 2.3% patients (from
51.0 ⫾ 3.8 cm3 up to 52.2 ⫾ 4.2 cm3).
IPSS index decreased in 33% patients
(from 16.8 3.98 to 11.2 ⫾ 2.24) after 5
months of treatment in patients with Adenoprosin, and in 7.6% patients from placebo group (from 18.2 ⫾ 3.7 to 16.8 ⫾
3.2). We observed the improving of the
life quality index by 3.4% (from 3.68 up
to 2.4) in patients treated with Adenoprosin and 3.2% (from 3.2 up to 3.1) in
the patients from placebo group. At the
5th month of treatment the urinary flow
speed was increased by 4.6 ml/s (in 33.3%
patients) from baseline in the first group
and decreased by 1.3 ml/s (12.2% patients) in placebo group. The residual
urine volume was reduced on by 12.2 ml
(in 22.7% patients) in the first group and
increased by 2.3 ml (4.7%) in placebo
group. PSA serum levels did not change
during treatment.
Conclusions: 1- Adenoprosin may induce
sclerosis changes and volume reduction
especially in BPH with glandular tissue. 2 Adenoprosin exerts a rapid and essential
improvement of the general symptoms
and urodynamic parameters in the first 3-4
weeks of treatment.- We consider that
prostate volume reduction occurs due to
both reducing of the paraprostatic edema
and venous retention in prostate tissue,
and influence on vascular phase of capillaries permeability in inflammation.
MP-09.08
Serum Prostate Specific Antigen Level
Predicts the Effectiveness of Silodosin
in Patients with Benign Prostate
Hyperplasia
Nakajima F1, Murai T2, Yanada S2,
Yuri Y2, Ohya K2, Kishimoto Y2,
Matsuzaki J2, Fukasawa R2, Kawakami S2,
UROLOGY 78 (Supplement 3A), September 2011
MODERATED POSTER SESSIONS
Torii T2, Mizuo T2
1
Keiyu Hospital, Yokohama, Kanagawa,
Japan; 2Yokohama LUTS Study Group,
Yokohama, Kanagawa, Japan
Introduction and Objective: Silodosin is
a highly selective alpha-1A antagonist that
is widely used in the treatment of benign
prostatic hyperplasia (BPH). We investigated the factors that influence the efficacy of silodosin.
Materials and Methods: One hundred
and thirty-two Japanese patients with
clinical BPH were entered into this
study from October 2008 to July 2010.
The dose of silodosin was 8 mg/day.
Serum prostate specific antigen (PSA),
international prostate symptom score
(IPSS), overactive bladder symptom
score (OABSS), and maximum flow rate
(Qmax) were recorded before and after
12 weeks on silodosin.
Results: IPSS decreased from 16.6 ⫾ 6.2
(mean ⫾ SD) to 10.9 ⫾ 6.2 (P⬍0.001),
Qmax increased from 10.73⫾ 5.46 to
12.29 ⫾ 6.09 mL/sec (P⫽0.051) and overactive bladder rate decreased from 59.2%
to 29.4%. Next, the background factors in
patients who showed improvement in
Qmax (group A: 8.69 ⫾ 4.07 to 13.89 ⫾
5.97 [mL/sec]) and those who did not
(group B: 12.85 ⫾ 6.26 to 9.85 ⫾ 4.53
[mL/sec]) were studied. Before treatment,
age, period of illness, IPSS and prostate
volume (PV) did not differ between the
two groups; however, PSA was lower in
group A (2.35 ⫾ 1.72 versus 4.98 ⫾ 6.04
)(P⫽0.0133). There was a positive correlation between PSA and PV (r⫽0.239,
P⫽0.0217) in all the patients; however,
PV did not differ between groups A and
B. Moreover, PSA density (PSAd: PSA / PV
[ng/mL/cc]) in group A (0.071 ⫾ 0.050)
was significantly lower than that in group
B (0.145 ⫾ 0.189) (P⫽0.0222). PSAd and
PV did not show correlation (r⫽0.138,
P⫽0.189). The reasons PSA and PSAd
were significantly lower in group A were
not clarified. Nevertheless, the results
showed that PSA production may be negatively correlated with the sensitivity to
silodosin and may suggest that higher PSA
and PSAd indicate a larger volume of glandular tissue and less capacity of smooth
muscle to relax under treatment with silodosin.
Conclusions: BPH patients with lower
PSA and PSAd showed a better response
to silodosin treatment, suggesting that
these factors may predict the effectiveness of alpha-1 antagonists and contribute to the selection of treatment.
MP-09.09, Table 1. Baseline characteristics of study patients.
Characteristics
Alfuzosin group Udenafil group Combination group
(nⴝ20)
(nⴝ21)
(nⴝ21)
Mean age (years)
62.0⫾7.3
61.0⫾5.9
59.8⫾6.3
Mean prostate volume (ml)
32.3⫾7.9
30.4⫾7.0
30.4⫾7.0
Mean IPSS*
18.3⫾4.2
16.2⫾6.1
18.0⫾6.4
Mean IPSS-QOL**
3.9⫾0.5
3.3⫾1.5
3.3⫾0.8
Mean IIEF***
14.9⫾4.7
12.8⫾3.5
61.0⫾5.9
Mean Qmax (ml/sec)
9.5⫾1.9
9.7⫾5.4
9.9⫾4.0
Mean post-void residual
35.3⫾21.0
38.0⫾23.0
32.5⫾21
urine volume (ml)
* International prostate symptom score, ** International prostate symptom score-quality of life,
*** International index of erectile function
MP-09.09
Efficacy and Safety of Combination of
Alfuzosin and Low Dose Udenafil
Once Daily versus Monotherapy in
Patients with Comorbid Lower
Urinary Tract Symptoms and Erectile
Dysfunction: Randomized Prospective
Open-label Study
Cho D3, Seo J1, Kim J1, Seo H1, Lee J1,
Lee W1, Kim J2, Kim G3
1
Top Urology Linic, Daegu, South Korea;
2
Daegu Fatima Hospital, Daegu, South
Korea; 3CHA University, Gumi CHA
Hospital, Gyeongsangbukdo, South
Korea
Introduction and Objective: The purpose of this study was to assess the efficacy and safety of the alfuzosin 10mg
once daily (OD), the PDE-5 inhibitor
udenafil 50mg OD, and the combination
of both on lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) with erectile
dysfunction (ED).
Materials and Methods: A randomized,
open-label, three-arm study was conducted
from September 2009 to February 2010.
Patients aged 50-76 year were randomized
to receive alfuzosin (n⫽20), udenafil
(n⫽21), or the combination of both (n⫽21)
for 12 weeks. International prostate symptoms score (IPSS), IPSS quality of life (IPSSQOL), maximum flow rate (Qmax), postvoid residual volume (PVR), transrectal
ultrasonography (TRUS) and erectile function domain of the international index of
erectile function (IIEF) were evaluated at
baseline, 6 and 12 weeks. Complications
were also evaluated.
Results: Baseline characteristics of patients were shown at table 1. There was
no statistical difference of baseline parameters in three groups. After 12 weeks,
changes in IPSS from baseline was significantly improved in Alfuzosin and combination groups ( Alfuzosin: ⫺17.4%, combination: ⫺26.7%, p⬍0.05, udenafil: ⫺1.8%,
p⬎0.05). Qmax and PVR were significant
UROLOGY 78 (Supplement 3A), September 2011
improved in Alfuzosin (Qmax and PVR
with percentage changes of 13.6%,
⫺27.9%, respectively, p⬍0.05) and combination groups (Qmax and PVR: 22.3%,
⫺26.4%, p⬍0.05). Improvement of IIEF
was significant with udenafil and combination treatments (combination: 52.1%, udenafil: 34.9%, p⬍0.05, alfuzosin: 8.0%,
p⬎0.05). Especially, IPSS, Qmax and IIEF
were significant improved in combination
treatment compared with alfuzosin or
udenafil only (p⬍0.05). All three treatments were well tolerated.
Conclusions: The combination treatment
of alfuzosin and low dose udanafil once
daily is more effective than monotherapy
in patients with comorbid ED and LUTS
suggestive of BPH, And combination treatment is also safe.
MP-09.10
Rapid Increases in Healthcare
Utilization and Cost Due to Benign
Prostatic Hyperplasia in South Korean
Males: Retrospective Population-Based
Analysis
Choi W1, Song S2, Jeong H3, Son H3,
Kang J4, Hong S5, Lee H6, Kim S7, Park B8,
Lee H9
1
Dept. of Urology, Yanggu Health Center,
Yanggu, South Korea; 2Dept. of Urology,
Seoul National University Hospital,
Seoul, South Korea; 3Dept. of Urology,
Seoul National University Boramae
Hospital, Seoul, South Korea; 4Dept. of
Urology, Eulji University Hospital, Seoul,
South Korea; 5Dept. of Urology, Seoul
National University Bundang Hospital,
Seoul, South Korea; 6Department of
Urology, Samsung Medical Center,
Sungkyunkwan University School of
Medicine, Seoul, South Korea; 7Medical
Research Collaborating Center, Seoul
National University Hospital, Seoul,
South Korea; 8Dept. of Preventive
Medicine, Seoul National University
College of Medicine, Seoul, South Korea;
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MODERATED POSTER SESSIONS
MP-09.10, Table 1. - Hospital visits and duration of treatment by age groups and by years
2004
2005
2006
2007
2008
Hospital visits Inpatient outpatient inpatient outpatient inpatient outpatient inpatient outpatient inpatient outpatient Sub total
20s
72
1,960
43
1,662
26
1,767
52
856
36
684
7,158
30s
924
19,474
1,099
20,207
1,299
20,311
1,247
17,225
760
16,837
99,383
40s
5,649
110,862
7,502
118,759
7,366
141,098
6,336
150,749
7,037
160,455 715,813
50s
21,263
341,120
24,517
382,598
29,495
464,709
29,654
504,770
26,379
553,075 2,377,580
60s
56,007
639,286
68,017
701,119
74,345
818,942
76,642
921,221
78,455 1,043,364 4,477,398
70s
44,946
444,778
52,426
510,746
68,036
616,242
82,399
716,297
83,302
833,513 3,452,685
⬎80s
15,582
124,806
16,101
142,189
23,133
166,459
28,483
189,011
32,525
220,689 958,978
Sub total
144,443 1,682,286 169,705 1,877,280 203,700 2,229,528 224,813 2,500,129 228,494 2,828,617
12,088,995
Total
1,826,729
2,046,985
2,433,228
2,724,942
3,057,111
Duration of
2004
2005
2006
2007
2008
Sub total
Treatment
inpatient outpatient inpatient outpatient inpatient outpatient inpatient outpatient inpatient outpatient
20s
111
2,414
123
1,925
86
1,855
86
927
57
844
8,428
30s
1,426
24,316
1,574
24,736
1,871
24,090
2,013
20,486
1,695
20,564 122,771
40s
7,761
136,217
10,142
143,254
10,533
175,727
9,925
189,279
11,550
206,786 901,174
50s
32,435
713,919
36,367
829,935
45,680
956,906
45,912
990,598
46,198 1,017,950 4,715,900
60s
92,490 1,017,676 105,926 1,256,252 119,984 1,624,750 126,144 2,047,781 134,570 2,597,312 9,122,976
70s
75,740 1,148,624
85,228 1,286,461 109,966 1,488,953 128,577 1,636,818 136,303 1,907,998 8,004,668
⬎80s
26,885
183,415
26,936
220,867
35,950
278,786
41,908
343,601
47,988
428,972 1,675,308
Sub total
236,848 3,226,672 266,296 3,763,430 324,070 4,551,067 354,565 5,229,490 378,361 6,220,426
24,551,225
Total
3,463,520
4,029,726
4,875,137
5,584,055
6,598,787
9
Dept. of Urology, Kyung Hee University
School of Medicine, Seoul, South Korea
Introduction and Objective: Korea is
rapidly becoming an aged society and it
seems certain that benign prostatic hyperplasia (BPH) will emerge as a topic of primary concern for health care service authorities. We investigated the amount of
healthcare utilization due to BPH and to
find any seasonal or regional variation in
the amount and cost of health care utilization.
Materials and Methods: The Health Insurance Review and Assessment service
(HIRA) database, which contains reimbursement records from all medical facilities in South Korea, was used in this
study. Patients aged 20 or older diagnosed
from 2004 to 2008 with BPH [ICD-10 diagnostic code: N40] as the primary diagnosis were included. Age and year-specific
amount of hospital visits (HVs), durations
of treatment (DT), the total and per capita
insurance payments (TAIPs and PCIPs)
and their seasonal variations were evaluated.
Results: A total of 12,088,995 HVs were
studied. Total HVs increased 1.7 times and
DTs almost doubled in 2008 as compared
with 2004. HVs, DTs, and TAIPs showed
linearly increasing patterns by year. Time
series analysis showed that HVs increased
in winter and demonstrated a seasonal
pattern. Poisson regression analysis
showed that annual variations in HVs,
DTs, TAIPs, and PCIPs differed by age. In
patients older than 40, HV significantly
S98
increased every year compared with the
previous year, and in patients in their 60s
and 80s, DTs were markedly higher than
in other age groups. The rate of increase
in PCIP was steeper for patients of ⱖ50
than for patients of ⬍50 years.
Conclusions: Healthcare utilization due
to BPH is increasing rapidly in South Korea and this increase is remarkable in the
elderly. Seasonal variations in HVs demon-
strated that health care utilization of BPH
patients increased during the winter.
MP-09.11
Prevalence of Benign Prostatic
Hyperplasia (BPH) and Lower Urinary
Tract Symptoms (LUTS) in Ghanaians
Yeboah E2, Hsing A5, Chokkalingham A1,
Biritwum R2, Tettey Y2, Jadallah S3,
MP-09.10, Figures A, B and C. Quarterly amount of; A. Hospital visits per month, B. Duration of
treatment per month, C. Total amount of insurance payment per month show seasonality
UROLOGY 78 (Supplement 3A), September 2011
MODERATED POSTER SESSIONS
Platz E3, Chu L4, Niwa S7, Thompson I6
1
School of Public Health of California,
Berkeley, USA; 2University of Ghana
Medical School, Accra, Ghana; 3Brady
Urological Institute, Baltimore, USA;
4
John Hopkins University, Baltimore,
USA; 5Division of Cancer Epidemiology
and Genetics NCI, Bethesda, USA;
6
University of Texas Health Science
Center, San Antonio, USA; 7Westat Inc,
Rockville, USA
Introduction and Objectives: BPH is
the commonest cause of urinary retention,
LUTS and haematuria in Ghanaian men.
Due to difficulties in defining LUTS and
BPH in population-based studies their impact on many populations is unclear.
Materials and Methods: We examined
the prevalence of BPH on DRE and LUTS
in probability sample of 950 Ghanaian
men aged 50 –74 in Accra who had no
prostate cancer. We elicited LUTS based
on International prostate symptom score
(IPSS) and severe LUTS. For subjects undergoing Transrectal ultrasound (TRUS)
guided biopsy of the prostate we estimated prostate volume. In the analysis we
used several definitions to derive age-standardized prevalence of estimates of BPH
and LUTS such as prostate size on DRE,
PSA ⱖ1.5ng/ml (estimate prostate vol.
ⱖ30 mls) and IPSS. Statistical analysis was
used randomly selected cases. Management of symptomatic BPH; These were
along the lines approved by IRB and were
dependent on IPSS score. Quality of life
(QOL), Peak flow Rate (PFR) and Post
void residual urine (PVR). Those with IPSS
0 – 7 were managed by watchful waiting.
Those with IPSS 8 – 19 were managed by
alpha adrenergic blockers ⫾ 5 alpha reductase inhibitors. Operations were performed for those with refractory retention
of urine, recurrent infection, excessive
bleeding, calculi, diverticula and uraemia
from obstructive uropathy. The operations
performed were transurethral incision of
prostate (TUIP) or resection of bladder
neck. Simple prostatectomy by Transurethral resection of prostate (TURP) for glands
⬍50G or open simple transvesical or retropubic prostatectomy for prostates ⬎50G.
Results: There were a total of 1038 men
studied. We excluded 88 men (73 with
prostate cancer and 15 with occult prostate cancer). The prevalence of DRE detected BPH was 62.3%. Using self-reported
IPSS the overall prevalence of moderate to
severe urinary symptoms was only 19%
and the prevalence of PSA ⱖ1.5ng/ml (an
estimate of prostate volume ⱖ 30cc) was
36.7%. The prevalence of DRE – BPH with
IPSS ⱖ 8 indicative of symptomatic prostate enlargement was 13.3%.
Conclusions: The prevalence of DRE –
detected BPH of 62.3% in Ghanaians is
higher than previously reported in other
populations while the prevalence of IPSS
ⱖ 8 of 19.9% was comparable to those of
previous populations but lower than those
reported separately for African Americans.
The study confirms that BPH and LUTS
are major health problems in Ghanaian
men aged 50 years and above.
MP-09.12
Prostatic Urethral Angulation Can
Predict Urinary Flow Rate and Urinary
Symptom Score in Men With Lower
Urinary Tract Symptom
Ham W1, Park S2, Lee S2, Kim T3,
Cho W3, Kim D4, Sung Y5, Yu H1, Cho K1
1
Dept. of Urology, Yonsei University,
College of Medicine, Seoul, South Korea;
2
Dept. of Urology, Hanyang University,
College of Medicine, Seoul, South Korea;
3
Dept. of Urology, Dong-A University,
College of Medicine, Busan, South Korea;
4
Dept. of Urology, Bonseng Hospital,
Busan, South Korea; 5Dept. of Urology,
Marrynol Hospital, Busan, South Korea
Introduction and Objective: Recently,
prostatic urethral angulation (PUA) has
been theoretically proposed as a new influencing factor on lower urinary tract
symptoms (LUTS). We evaluated the association between PUA and peak flow rate
(Qmax) and urinary symptoms in the
clinic setting.
Materials and Methods: The records of
first-visit men with LUTS between Apr
2010 and Sep 2010 were reviewed. Uroflowmetry, post-void residual, International Prostatic Symptom Score (IPSS),
serum prostate specific antigen levels, and
urinalysis were checked. Prostate-related
parameters including volume, PUA, and
intravesical prostatic protrusion (IPP)
were prospectively measured by transrectal ultrasonography. Patients with comorbidities which may affect voiding function
were excluded.
Results: A total of 156 patients were included and their mean age was 62.2⫾11.0
years. Mean total prostate volume (TPV),
transitional zone volume (TZV), and transitional zone index (TZI) were 28.7⫾9.8
ml, 11.3⫾6.6ml, and 0.37⫾0.11, respectively. Mean PUA and IPP were 45.7⫾9.2°
(11.9-66.3) and 2⫾3mm (0-16). Mean IPSS
score and Qmax were 14.6⫾7.1 and
14.9⫾7.3mL/s. On multiple linear regression models, PUA (p ⬍ 0.001) and TZI
(p ⫽ 0.021) were independently associ-
UROLOGY 78 (Supplement 3A), September 2011
ated with IPSS score. However, IPSS score
was not influenced by TPV, TZV and IPP.
Mean PUA according to symptom severity
was significantly different: Mean PUA was
41.0⫾7.7° in patients with mild symptoms, 45.8⫾9.4° in those with moderate
symptoms, and 49.0⫾8.3° in those with
severe symptoms (p ⫽ 0.002). Meanwhile,
PUA (p ⬍ 0.001), TZI (p ⫽ 0.015), and
TZV (p ⫽ 0.024) were independent predictors of Qmax, but which was not affected by TPV and IPP. Mean PUA was
50.8⫾7.4° in patients with
Qmax⬍10mL/s, 46.3⫾8.2° in those with
Qmax ⬎ 10mL/s and ⬍ 20mL/s, and
38.2⫾8.5° in those with Qmax ⬎ 20mL/s
(p ⬍ 0.001).
Conclusions: Among prostate-related
parameters, PUA is the most potent predictor of peak flow rate and symptom
scores in men with LUTS. Our finding suggests that PUA should be considered in
the management of male LUTS patients.
MP-09.13
Contribution of Common Medications
to Lower Urinary Tract Symptoms
Among Community Dwelling Men
Wuerstle M1, Van Den Eeden S2,
Poon K3, Quinn V3, Hollingsworth J4,
Loo R5, Jacobsen S3
1
Dept. of Urology, Kaiser Permanente
Southern California, Los Angeles Medical
Center, Los Angeles, USA; 2Division of
Research, Kaiser Permanente Northern
California, Oakland, USA; 3Dept. of
Research and Evaluation, Kaiser
Permanente Southern California,
Pasadena, USA; 4Department of Urologic
Surgery, University of Michigan, Ann
Arbor, USA; 5Dept. of Urology, Kaiser
Permanente Southern California,
Bellflower Medical Center, Downey, USA
Introduction and Objective: The causes
of male lower urinary tract symptoms
(LUTS) are likely multifactorial and may
include concomitant medication use. Motivated by this, we performed a cross-sectional study examining the association
between commonly prescribed medications and LUTS.
Materials and Methods: Through the
California Men’s Health Study (CMHS), we
identified men between 45 and 69 years
of age, who were members of the Kaiser
Permanente Northern and Southern California Health plans. Of 84,170 participants, 63,579 met inclusion criteria. The
use of specific medications (i.e., antidepressants, antihistamines, bronchodilators,
anticholinergics, sympathomimetics, and
diurectics) was determined through phar-
S99
MODERATED POSTER SESSIONS
macy records. We assessed LUTS through
responses to the American Urological Association Symptom Index. We modeled
the association between a LUTS and medication use, adjusting for age, race/ethnicity, region, and prostate size. With this
information, we determined the proportion of a man’s LUTS that could be attributable to his medication use.
Results: With the exception of sympathomimetics, all examined medications were
associated with a higher odds of LUTS
(e.g., for antihistamines, odds ratio [OR],
1.17; 95% confidence interval [CI] 1.12 –
1.23). After adjustment, bronchodilators
and antidepressants had the strongest association (OR⫽1.22; 95% CI, 1.15-1.29
and OR, 1.39; 95% CI, 1.32-1.47, respectively). The adjusted OR for any study
medication use and LUTS was 1.29
(95%CI, 1.25-1.34). When stratified by the
report of an enlarged prostate, the associations were strongest among those participants without an enlarged prostate. Based
on these associations, the fractions that
could be attributed to bronchodilators,
diuretics and antidepressants were 2.2%,
2.9% and 3.7%, respectively. The use of
any study drug could account for 10% of
LUTS.
Conclusions: A significant proportion of
LUTS may be attributable to the use of
many common medications in communitydwelling men, especially those not having
been told they had an enlarged prostate.
This underscores the importance of evaluating current medication use in clinical
evaluations as well as in research studies
of LUTS.
MP-09.14
Comparison Between 70w-120w-150w
in the Vaporesection of BPH With
Thulium Laser
Mattioli S, Picinotti A, Sabatino M
The Laser Urology Centre, Arezzo, Italy
Introduction and Objective: The Thulium Laser is a urological surgical Laser
used in the treatment of BPH. Several
studies showed that Thulium Laser is a
safe, effective and bloodless procedure at
70W that 120 W. The aim of our study is
to report our experience in the treatment
of BPH with Thulium Laser 150 W comparing it to the results of 120W and 70W.
Material and Method: From May 2004
to January 2010, we treated a total of 530
patients (age ranged: 41 – 85 yrs) with
BPH using Thulium Laser. There were 310
pts with 70W (Group 1), 120 pts with
120W (Group 2), 105 pts with 150W
(Group 3). Prostatic volume range: 30 –
S100
110 gr. Vaporesection, in continuous
wave, is a protocol used to vaporize tissue
and resect the prostate. The Thulium Laser was used in conjunction with a frontal
and side fibre. At the end of procedure a
new Wolf Morcellator was employed for
treat large pieces. The catheter was removed 48 hours later. Discharge after 72
hour.
Results: Mean operative time: 65 min
with Group1; 50 min with Group2; 50
min with Group3. No major complications
were reported. At a follow-up of 6 mts,
comparing the pre and post operative parameters (AUA-SS, Mean QMax, PVR), in
all three groups, we had a total resolution
of obstruction. The patients refered discomfort: 7/310 (2.25%) pts in Group1; 0
pts in Group 2; 6/105 (5.71%) pts in
Group 3. Bladder neck sclerosis developped in 5/310 (1,61%) pts in Group 1;
1/120 (0.83%) pts in Group 2 and 3/105
(2,85%) pts in Group 3. A statistical difference is between the percentage of discomfort between the Group 3 and Group
1-2 and the percentage of bladder neck
sclerosis between Group 3 and 2, no difference in the utilized number of fibers.
Conclusion: The use of Thulium Laser
for Vaporesection of the prostate is safe
and efficacy also to high power as 120 W
and 150W in particular in the treatment
of large prostates without prolonged operative time. Nevertheless, our results suggested that there are not advantages in
the use of 150W if we considered the
higher risk of discomfort syndrome and
bladder neck sclerosis.
MP-09.15
Photoselective Vaporization of
Prostate vs TURP: A Prospective,
Randomized Study with 1 Year
Follow-Up
Mohanty N, Vasudeva P, Kumar A,
Arora R
V.M.Medical College & Safdarjang
Hospital, New Delhi, India
Introduction and Objective: To evaluate the efficacy and safety of KTP-PVP
(Potassium titanyl phosphate- photoselective vaporization of prostate) when compared to TURP for management of LUTS
due to BPE.
Materials and Methods: In a prospective, randomized study conducted between February 2009 and August 2009,
consecutive patients with lower urinary
tract symptoms (LUTS) secondary to benign prostatic enlargement (BPE) who
satisfied the inclusion/exclusion criteria
were planned for surgery according to the
International BPH guidelines of the American Urology Association were randomized
to one of two Groups. Group A: Underwent PVP using the 80W KTP laser.
Group B: Underwent standard TURP. Primary outcome measures for group analysis included subjective (IPSS, QOL, IIEF5)
and objective (Prostate volume, PVRU and
Q max) parameters at 1, 3, 6 and 12
months. Secondary outcome measures
analyzed included various perioperative
parameters and complications, if any. Data
was analyzed using SPSS version 12.0. and
P values ⬍0.05 were considered statistically significant.
Results: Of 128 patients randomized, 117
were available for analysis. Follow-up data
at 1, 3, 6 and 12 months was available for
60, 60, 58, 52 and 57, 55, 50, 50 patients
in group A and B , respectively. Baseline
characteristics did not differ significantly
between the two groups. Both groups
showed significant improvement in the
IPSS score, QOL score, prostate volume,
Q max and PVRU at each of the follow-up
visits with no significant differences noted
between the 2 groups except for QOL
score at 1 month which was significantly
better in group B. The need, amount and
duration of postoperative irrigation, perioperative haemoglobin drop and duration
of postoperative catheterization were all
significantly lesser in group A as compared to group B. Clot retention and
blood transfusion rates were significantly
higher in Group B than Group A while
dysuria was higher in Group A than
Group B.
Conclusion: KTP-PVP is an equally efficacious alternative to TURP in the management of LUTS due to BPE with durable
results at 1 year follow-up. It has the
added benefits of significantly lesser perioperative blood loss and transfusion requirements along with a shorter catheterization time.
MP-09.16
Does a Patient With Parkinson’s
Disease and Benign Prostatic
Obstruction or Hypocontractility of
the Detrusor Benefit From a
Transurethral Resection of the
Prostate
Neisius A1, Neisius Y2, Wöllner J3,
Thüroff J1, Hampel C1
1
Dept. of Urology, Johannes Gutenberg
University, Mainz, Germany; 2Dept. of
Paediatrics, Hospital Worms, Worms,
Germany; 3Dept. of Neuro-Urology,
Spinal Cord Injury Center, Balgrist,
University Zurich, Zurich, Switzerland
UROLOGY 78 (Supplement 3A), September 2011
MODERATED POSTER SESSIONS
Introduction and Objective: In common opinion and according to the current
literature, patients with Parkinson’s disease and Benign Prostatic Obstruction or
Hypocontractility of the detrusor have an
increased risk of a postoperative urinary
incontinence. The number of patients in
studies published so far does not exceed
the maximum 23 cases. Therefore, we
analyzed the outcome after transurethral
resection of the prostate in patients with
a neurological proven Parkinson’s disease.
Materials and Methods: All in all a total
amount of 41 patients with proven Parkinson’s disease, who underwent transurethral resection of the prostate because of
benign prostatic obstruction or detrusor
hypocontractility, were retrospectively
analyzed. Patients with multiple system
atrophy or any other systemic neurological disorders were excluded.
Results: The median patient age at intervention was 75 years. Twelve of 41 patients had a preoperative indwelling catheter, in 8 (67%) of the 12 patients voiding
was possible postoperatively but in 2
(17%) of these 8 patients a de novo stress
urinary incontinence occurred. Four
(33%) required an indwelling Foley catheter afterwards. From another 10 patients
with preoperative urge incontinence 7
(70%) recovered continence, 2 (20%)
were significantly less incontinent and
only 1 (10%) remained as incontinent as
before the intervention. In 4 of 41 cases
(10%) a de novo (Stress) urinary incontinence was ascertained three months after
transurethral resection of the prostate. At
a median follow up of three years transurethral resection in patients with a Parkinson’s disease were successful in 30 of
41 (73%) cases.
Conclusions: Patients with a Parkinson’s
disease and benign prostatic obstruction
or hypocontractility of the detrusor do
benefit in up to 73% and the risk of a
postoperative de novo urinary incontinence seams quite low. In conclusion,
Parkinson’s disease should not be mandatory esteemed as a contraindication for a
transurethral resection of the prostate.
Nevertheless a preoperatively performed
urodynamic investigation is obligatory to
prove bladder outlet obstruction or detrusor hypocontractility.
MP-09.17
Medication Adherence and Strategies
for Improvement of Tamsulosin in
the Elderly Benign Prostatic
Hyperplasia Patients
Oh-Oka H
Dept. of Urology, Kobe Medical Center,
Kobe, Japan
Introduction and Objective: I examine
the medication adherence of elderly benign prostatic hyperplasia (BPH) patients
(75 years or older) and strategies for improvement of adherence.
Materials and Methods: There were 200
patients over 75 years old who regularly
visit my department for treatment of BPH,
and take tamsulosin (tam.) under stable
micturition for more than three years
(IPSS; 8-12, median;10, IPSS-QOL; 0-3, median; 2). From January 2010, I confirmed
medication adherence at patient revisit of
hospital after having obtained a written
informed consent from relatives (in 99.0%
a spouse), where I prescribe tam. for 8
weeks after examination (we do not notify patients themselves regarding medication adherence). And I have randomly assigned 50 to the next four groups; A)
usual medical examination, testing and
prescribe tam., B) I ask outside Parliament
drugstore pharmacists for more detailed
explanation and guidance including importance of medication adherence (more
than 4 times for 8 weeks), C) Explanation
and education regarding importance of
adherence to relatives from physicians,
staffs and ask for promoting medication
when patients do not take medicine at
home, and D) Chief doctor contacts the
home on the telephone after dinner about
micturition once within 1-2 weeks. I compared medication adherence between
above-mentioned four groups. In addition,
92.5% of patients (185/200) took 2-10
other oral medicine (median; 4.0).
Results: The original medication adherence was 81.0% (162/200). After the subsequent classification to four groups,
group A; 80.0% (40/50), group B; 84.0%
(42/50), group C; 78.0% (39/50), and revealed significant improvement with
group D; 98.0% (49/50) (Between group
A and D, p⫽0.004). Background factors
do not show a significant difference between each group.
Conclusion: The maintenance of the adherence at the treatment of various diseases for elderly people is important, and
medication adherence in Japan is not
good. The oral medicine tends to increase
in morning, which is one of the major
causes to decrease medication adherence
including observance of medication time.
My data suggest that the construction of a
good relationship of mutual trust between
the patients and the attending physician
influences medication adherence, and aggressive communications from physicians
are also important.
UROLOGY 78 (Supplement 3A), September 2011
MP-09.18
Diode Laser Vaporization of the
Prostate in comparison with
Transurethral Resection of the
Prostate for Benign Prostatic
Hyperplasia: Preliminary Results of a
Randomized Clinical Trial
Razaghi M, Mokhtarpour H,
Mazloomfard M
Laser Application in Medical Sciences
Research Center, Tehran, Iran
Introduction: Transurethral resection of
the prostate (TURP) is still the standard
treatment of benign prostatic hypertrophy (BPH) but the surgical lasers recently introduced seem to offer the patient a very low perioperative
complication rate, a short learning
curve, and reduced operating time. A
recently introduced high-powered diode
laser (980nm) offers a simultaneous absorption in water and hemoglobin but is
lacking clinical experience. In this clinical trial study, the feasibility, and postoperative outcome of vaporization of
prostate by means of a diode laser were
investigated and compared with TURP
as a gold standard treatment.
Material and Methods: From January
2007 to January 2009, 100 patients with
lower urinary tract symptoms suggestive
of benign prostatic hyperplasia were
included in this study. Using computergenerated simple random tables in a 1:1
ratio, patients were assigned to two fifty-patient groups according to the
method of surgical treatment: TURP and
high-powered diode laser (980nm). All
patients underwent physical examination and evaluation of symptoms according to the International Prostate Symptoms Score (IPSS). Blood tests included
blood cell count, serum chemistry, serum prostate-specific antigen (PSA), and
urine analysis. Additionally, post-void
residual urine volume (PVR) and the
peak urinary flow rate (Qmax) were measured. Prostate size were assessed by
transrectal ultra-sound (TRUS). Demographic characteristics, the duration of
the operation, the changes in hemoglobin and serum sodium, the complications, the hospitalization period and the
duration of indwelling catheter were
compared between the two aforesaid
groups. Functional results in terms of
improvement of IPSS, Qmax, and PVR
urine were assessed at 1, 6, and 12
months.
Result: The mean ⫾ SD age of the patients was 68.2⫾7.8 years (TURP) and
68.5⫾8.8 years (Diode), with a mean
S101
MODERATED POSTER SESSIONS
preoperative prostate volume of
59.6⫾14.1 and 61.1⫾16.1 mL, respectively. In TURP and Diode groups, the
operation time was 54.9⫾15.3 vs.
60.6⫾22.6 minutes (p⫽0.14); Foley
catheterization time, 50.8⫾22.5 vs.
20.1⫾4.6 minutes (p⫽0.0001); and postoperative hospital stay was 4.2⫾0.8 vs.
1.8⫾0.4 (p⫽0.0001) respectively. The
mean ⫾ SD energy delivery with the
diode laser was 145.8⫾19.9 kJ. Among
patients of TURP, capsule perforation
was observed in 5 patients (10%), 6
S102
(12%) required blood transfusion and 2
(4%) developed TUR syndrome during
surgery; whereas none of these complications were observed in the Diode
group. One patient in the TURP group
required redo-TURP, while two patients
of the Diode group required redo-TURP.
Outcome in regards to increase in Qmax,
decrease in IPSS, and decrease in PVR
show a dramatically improvement in the
three parameters compared with preoperative values and the degree of improvement was comparable in both
groups at all time points of follow-up (1,
6 and 12 months post-operatively).
Conclusion: The gold standard treatment in patient suffering lower urinary
tract symptoms due to BPH is TURP.
According to our study high-powered
diode laser (980nm) offers a safe and
feasible procedure in the management
of patients with symptomatic BPH with
lower complication rate. However, time
of operation and need for future treatment increase in this technique.
UROLOGY 78 (Supplement 3A), September 2011