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Proceedings Paper

Therapeutic efficacy and safety of photo-selective vaporization of prostate under local anaesthesia with light sedation
Author(s): Carl-Jørgen Arum M.D.; Paal Romundstad; Jan Mjønes M.D.
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Paper Abstract

OBJECTIVES: We evaluated the therapeutic efficacy and safety of photo-selective vaporization of the prostate (PVP) under local anaesthesia in patients suffering from lower urinary tract symptoms (LUTS) secondary to prostatic obstruction. MATERIAL & METHODS: 150 patients at the average age of 73 (range 51-92) and a mean/median ASA-score of 2.4/2.0 were included. PVP was performed under either general or spinal anaesthesia in the first 67 patients and under local anaesthesia (peri-prostatic infiltration with 0.25% bupivacain-adrenalin 20 ml) and light sedation in the remaining 83 patients. Surgical variables including asa-score, operative-time, blood-pressure, oxygen saturation, pre- and post-op haemoglobin (Hgb) were recorded. Post operative need for pain medication, catheter-time, and time to pts. hospital discharge were also recorded. RESULTS: No patient with local anaesthesia required conversion to general anaesthesia. The median Hgb fall from pre-op. to post-op. was 0.55g/dl. The median requirement for post-op. catheterization was 2 hrs after local anaesthesia and 9 hrs after general or spinal anaesthesia. The median time from operation to hospital discharge was 12 hrs in local anaesthesia and 24 hrs for general or spinal anaesthesia (p<0.001). At 12 and 18 months postoperatively, the following factors were significantly (p<0.001) improved: trans-rectal ultrasound, international prostate symptom score, quality of life score, post-void residual urine volume, flow max/average. At 12 months urodynamic studies revealed significant improvement (p<0.001) for opening pressure, pressure @ flow-max, micturation resistance and bladder outlet obstruction index. CONCLUSION: PVP under local anaesthesia and light sedation provides excellent intraoperative safety, expedient post operative recovery, significant symptom relief as well as improvement in uro-dynamic outcomes.

Paper Details

Date Published: 23 March 2007
PDF: 6 pages
Proc. SPIE 6424, Photonic Therapeutics and Diagnostics III, 64241D (23 March 2007); doi: 10.1117/12.708412
Show Author Affiliations
Carl-Jørgen Arum M.D., St. Olavs Univ. Hospital in Trondheim (Norway)
Norwegian Univ. of Science and Technology (Norway)
Paal Romundstad, Norwegian Univ. of Science and Technology (Norway)
Jan Mjønes M.D., St. Olavs Univ. Hospital in Trondheim (Norway)

Published in SPIE Proceedings Vol. 6424:
Photonic Therapeutics and Diagnostics III
Henry Hirschberg M.D.; Brian Jet-Fei Wong M.D.; Reza S. Malek M.D.; Kenton W. Gregory M.D.; Nikiforos Kollias M.D.; Bernard Choi; Steen J. Madsen; Guillermo J. Tearney M.D.; Justus F. R. Ilgner M.D.; Haishan Zeng, Editor(s)

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