Presentation Authors: Laura Zuluaga*, Mauricio Plata, Carlos Gustavo Trujillo, Catalina Barco-Castillo, Jessica Santander, Daniela Robledo, Juan Ignacio Caicedo, Julian Azuero, Martin Rondón, Bogotá DC, Colombia
Introduction: Energy density (ED) measures the optimization of laser use in relation to prostate volume (PV). This seems to be related with adequate tissue removal and improved long terms outcomes in patients who are being treated with prostate photovaporization (PVP). Is not clear which range of ED should be provided to guarantee safe and durable results. Our aim is to assessED (kJ/mL) on functional outcomes and complications.
Methods: Data were retrospectively collected from a referral center between 2012 and 2017. Three groups of ED were stratified according to intra-operative energy delivered to the prostate. Group 1: â‰¤ 3.0; group 2: 3.0 - 5.0 and group 3: â‰¥ 5.0 kJ/mL. Functional outcomes as PSA drop, IPSS improvement (defined as a drop of â‰¥4 points), quality of life (QoL) and symptomatic improvement (VAS) were estimated. Peri and postoperative outcomes were assessed with Clavien-Dindo classification. Descriptive and inferential statistics were used.All analyses were performed using 24.0 SPSS software.
Results: A total of 573 patients were included in the analysis. Mean age was 69, 66, 65 and PV was 81, 75 and 51.5 mL respectively (P= < 0.001). Table 1 shows preoperative characteristics. Functional outcomes were equivalent among the groups except for PSA drop after the procedure: 6%, 35% and 35% for the ED groups 1, 2 and 3(P = 0.05). An inter-variable data analysis was done finding significant difference (P= 0,025) specifically between groups 3 and 1. ED was not associated with higher complication rates according to Table 2.
Conclusions: Higher energy usage per mL (>3 kJ/mL) correlates to greater PSA drop in a mean follow up of 28 months. This suggests an increased vaporization of adenoma and might correspond to better functional outcomes. Larger ED applied is not associated with increased complication rates.