Photovaporisation of the prostate using KTP laser in patients on antithrombotics. About a restrospective study of 120 cases

Antithrombotic (AT) medications are more and more prescribed, so complicating the surgery of benign prostatic hyperplasia (BPH). KTP laser is an alternative to the transurethral resection of the prostate thanks to its haemostatic properties. To study the functional outcomes and complications of KTP 80W laser treatment in patients taking AT, comparing with patients without AT (nAT). A single-center retrospective study has been conducted in the department of Urology of Nice Teaching Hospital, in patients with uncomplicated symptomatic BPH, treated with the KTP 80W laser treatment, between November 2005 and October 2009. The cohort was divided into two matched groups AT/nAT. In the AT group patients, treatment with aspirin and vitamin K antagonist (VKA) were maintained, whereas clopidogrel was discontinued. The urinary flowmetry, measurement of residual urine, International Prostate Symptom Score (IPSS) and question 8 of the IPSS score were analyzed. The duration of intervention, the amount of laser energy delivered, duration of catheterization and postoperative hospitalization, and the rate of blood transfusion have been evaluated. Clavien classification was used to characterize the postoperative complications. A total of 120 patients were included in two groups (50 AT/70 nAT), with a median follow-up of 24 months. The two study groups were comparable except for age which was significantly higher in patients on AT (P=0.001). The average duration of operation, of catheterization and hospital stay were significantly longer in patients receiving AT. Seven complications were reported in the AT group versus three complications in the nAT. No significant difference was reported on the evaluation of voiding parameters and IPSS score. Photovaporisation of the prostate using KTP 80W laser treatment provided functional outcomes comparable in patients on AT and untreated patients, with minimal risk of complication.