Randomized clinical trial comparing low power-slow heating versus high power-rapid heating noncontact neodymium: yttrium-aluminum-garnet laser regimens for the treatment of benign prostatic hyperplasia

Eduardo Orihuela, Thomas Cammack, Massoud Motamedi, Lahaye Marcel, Pow Sang Mariela, Torres Jorge, DeAngelis Adrienne, Michael M. Warren

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To evaluate and compare the safety and effectiveness of two noncontact laser regimens for the treatment of human benign prostatic hyperplasia (BPH), and to assess the impact of the spatial distribution of the laser-induced lesions on treatment outcome. Methods: This was a prospective, double-blind, randomized study that included 29 patients with BPH (both the patients and the study physician assistant in charge of the follow-up evaluation were blinded to the treatment rendered). The patients were randomized to receive either a 15 W for 180 s (15 patients) or 50 W for 60 s (14 patients) laser regimen (powers measured at the fiber tip). There were two study phases for each treatment group: the irradiated sites were not overlapping during the first phase (lesions 1.5 cm apart), and were overlapping during the second phase (lesion less than 1.0 cm apart). Results: Morbidity was minimal in both groups. At 1 year of follow-up, there was sig nificant improvement of the American Urological Association-7 symptom score, the peak urinary flow rate, and the postvoid residual in both treatment groups. These improve ments were not statistically significantly different regardless of time or the phase of the study for the two treatment groups. There were 3 treatment failures, 2 of whom were later successfully re-treated with larger amounts of laser energy. Furthermore, the peak flows in the second phase of the study were statistically significantly higher than those in the first phase of the study, regardless of the treatment group. Conclusions: Our results suggest that both the 15 W for 180 s and the 50 W for 60 s are equally safe and effective treatments for BPH. Perhaps more importantly, they also suggest that the spatial distribution of lesions and overlapping of treated (irradiated) sites has significant impact on treatment outcome.

Original languageEnglish (US)
Pages (from-to)783-789
Number of pages7
JournalUrology
Volume45
Issue number5
DOIs
StatePublished - 1995

Fingerprint

Neodymium
Solid-State Lasers
Prostatic Hyperplasia
Heating
Randomized Controlled Trials
Lasers
Therapeutics
Physician Assistants
Treatment Failure
Double-Blind Method
Morbidity
Safety

ASJC Scopus subject areas

  • Urology

Cite this

Randomized clinical trial comparing low power-slow heating versus high power-rapid heating noncontact neodymium : yttrium-aluminum-garnet laser regimens for the treatment of benign prostatic hyperplasia. / Orihuela, Eduardo; Cammack, Thomas; Motamedi, Massoud; Marcel, Lahaye; Mariela, Pow Sang; Jorge, Torres; Adrienne, DeAngelis; Warren, Michael M.

In: Urology, Vol. 45, No. 5, 1995, p. 783-789.

Research output: Contribution to journalArticle

Orihuela, Eduardo ; Cammack, Thomas ; Motamedi, Massoud ; Marcel, Lahaye ; Mariela, Pow Sang ; Jorge, Torres ; Adrienne, DeAngelis ; Warren, Michael M. / Randomized clinical trial comparing low power-slow heating versus high power-rapid heating noncontact neodymium : yttrium-aluminum-garnet laser regimens for the treatment of benign prostatic hyperplasia. In: Urology. 1995 ; Vol. 45, No. 5. pp. 783-789.
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abstract = "Objectives: To evaluate and compare the safety and effectiveness of two noncontact laser regimens for the treatment of human benign prostatic hyperplasia (BPH), and to assess the impact of the spatial distribution of the laser-induced lesions on treatment outcome. Methods: This was a prospective, double-blind, randomized study that included 29 patients with BPH (both the patients and the study physician assistant in charge of the follow-up evaluation were blinded to the treatment rendered). The patients were randomized to receive either a 15 W for 180 s (15 patients) or 50 W for 60 s (14 patients) laser regimen (powers measured at the fiber tip). There were two study phases for each treatment group: the irradiated sites were not overlapping during the first phase (lesions 1.5 cm apart), and were overlapping during the second phase (lesion less than 1.0 cm apart). Results: Morbidity was minimal in both groups. At 1 year of follow-up, there was sig nificant improvement of the American Urological Association-7 symptom score, the peak urinary flow rate, and the postvoid residual in both treatment groups. These improve ments were not statistically significantly different regardless of time or the phase of the study for the two treatment groups. There were 3 treatment failures, 2 of whom were later successfully re-treated with larger amounts of laser energy. Furthermore, the peak flows in the second phase of the study were statistically significantly higher than those in the first phase of the study, regardless of the treatment group. Conclusions: Our results suggest that both the 15 W for 180 s and the 50 W for 60 s are equally safe and effective treatments for BPH. Perhaps more importantly, they also suggest that the spatial distribution of lesions and overlapping of treated (irradiated) sites has significant impact on treatment outcome.",
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AU - Orihuela, Eduardo

AU - Cammack, Thomas

AU - Motamedi, Massoud

AU - Marcel, Lahaye

AU - Mariela, Pow Sang

AU - Jorge, Torres

AU - Adrienne, DeAngelis

AU - Warren, Michael M.

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N2 - Objectives: To evaluate and compare the safety and effectiveness of two noncontact laser regimens for the treatment of human benign prostatic hyperplasia (BPH), and to assess the impact of the spatial distribution of the laser-induced lesions on treatment outcome. Methods: This was a prospective, double-blind, randomized study that included 29 patients with BPH (both the patients and the study physician assistant in charge of the follow-up evaluation were blinded to the treatment rendered). The patients were randomized to receive either a 15 W for 180 s (15 patients) or 50 W for 60 s (14 patients) laser regimen (powers measured at the fiber tip). There were two study phases for each treatment group: the irradiated sites were not overlapping during the first phase (lesions 1.5 cm apart), and were overlapping during the second phase (lesion less than 1.0 cm apart). Results: Morbidity was minimal in both groups. At 1 year of follow-up, there was sig nificant improvement of the American Urological Association-7 symptom score, the peak urinary flow rate, and the postvoid residual in both treatment groups. These improve ments were not statistically significantly different regardless of time or the phase of the study for the two treatment groups. There were 3 treatment failures, 2 of whom were later successfully re-treated with larger amounts of laser energy. Furthermore, the peak flows in the second phase of the study were statistically significantly higher than those in the first phase of the study, regardless of the treatment group. Conclusions: Our results suggest that both the 15 W for 180 s and the 50 W for 60 s are equally safe and effective treatments for BPH. Perhaps more importantly, they also suggest that the spatial distribution of lesions and overlapping of treated (irradiated) sites has significant impact on treatment outcome.

AB - Objectives: To evaluate and compare the safety and effectiveness of two noncontact laser regimens for the treatment of human benign prostatic hyperplasia (BPH), and to assess the impact of the spatial distribution of the laser-induced lesions on treatment outcome. Methods: This was a prospective, double-blind, randomized study that included 29 patients with BPH (both the patients and the study physician assistant in charge of the follow-up evaluation were blinded to the treatment rendered). The patients were randomized to receive either a 15 W for 180 s (15 patients) or 50 W for 60 s (14 patients) laser regimen (powers measured at the fiber tip). There were two study phases for each treatment group: the irradiated sites were not overlapping during the first phase (lesions 1.5 cm apart), and were overlapping during the second phase (lesion less than 1.0 cm apart). Results: Morbidity was minimal in both groups. At 1 year of follow-up, there was sig nificant improvement of the American Urological Association-7 symptom score, the peak urinary flow rate, and the postvoid residual in both treatment groups. These improve ments were not statistically significantly different regardless of time or the phase of the study for the two treatment groups. There were 3 treatment failures, 2 of whom were later successfully re-treated with larger amounts of laser energy. Furthermore, the peak flows in the second phase of the study were statistically significantly higher than those in the first phase of the study, regardless of the treatment group. Conclusions: Our results suggest that both the 15 W for 180 s and the 50 W for 60 s are equally safe and effective treatments for BPH. Perhaps more importantly, they also suggest that the spatial distribution of lesions and overlapping of treated (irradiated) sites has significant impact on treatment outcome.

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