V5-04: Combined photovaporisation of prostate and laser cystolithotripsy using GreenLight Laser
Bladder stones in elderly men are commonly associated with bladder outlet obstruction. To date, there are many different treatment modalities have been presented for both these conditions. The aim of this study is to evaluate the safety and feasibility of a novel approach to photovaporise prostate as well as laser cystolithotripsy as an alternative method of utilizing GreenLight laser only.
In a prospective study conducted between January 2013 to July 2016, 23 patients with significant bladder outlet obstruction with presence of bladder calculi underwent both photovaporisation of prostate and cystolithotripsy in a single operation using single instrument via GreenLight laser. Patients diagnosed with bladder calculi and concurrent prostate hyperplasia underwent lithotripsy using greenlight photovaporisation side firing after completion of photovaporisation of the prostate were included in this study.
_x000D_ Twenty five patients underwent simultaneous laser cystolithotripsy and photovaporisation of prostate. The median Median patient age was 67 years (range 59-89). Median pre-operative prostate volume was 70cc (range 38-160). Stone size ranging from 1 - 4cm with variable number of stones (1-18) were fragmented with good results, bladder debris washout. There were no complications. An average of 316000 Joules were used to treat both vesical calculi and BPH. Majority of calculi analysis showed mixture of calcium oxalate, calcium phosphate and uric acid. Laser fiber lasted through both procedures without damage and not requiring replacement throughout the surgery. One case required percutaneous cystostomy for stone extraction.
The findings on this study shows that GreenLight laser is a minimally invasive and safe technique to treat both enlarged prostate with bladder calculi. This method can be used as an alternative method of treatment by using single instrument approach and could possibly prevent potential open procedure.