Diode Laser Vaporization for Benign Prostate Hyperplasia: Outcome After 126 Procedures.

Purpose: Photoselective vaporization of the prostate (PVP) with a 940-nm diode laser is an option for treating symptoms caused by benign prostatic hyperplasia (BPH). Here, we present our experience using this technology. Methods: We prospectively evaluated 126 patients with lower urinary tract symptoms (LUTS) secondary to BPH who underwent PVP with a 940-nm diode laser from January 2011 to January 2014. The patients were assessed using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, prostate-specific antigen (PSA) level, maximum urinary flow (Qmax) by uroflowmetry, postvoid residual volume, and prostate volume by ultrasound at baseline and 3, 6, 12, and 24 months after the procedure. Results: The average patient age was 68.8 ± 8.7 years (range 48-90 years), whereas the average preoperative parameters were as follows: IPSS, 26.1 ± 5.2; IPSS-QoL, 4.9 ± 0.8; Qmax, 4.5 ± 3.1 mL/s; prostate volume, 76.5 ± 35.5 mL; and PSA level, 3.9 ± 2.6 ng/mL. The average catheterization time was 24.7 ± 25.5 hours (range 3-120 hours), and the length of hospital stay was 22.4 ± 17.0 hours (range 8-144 hours). The mean follow-up duration was 17.9 months (range 1-36 months). All parameters showed significant improvement after 12 months. After 24 months, the IPSS (8.8 ± 5.4, p < 0.07), IPSS-QoL (1.6 ± 0.9, p < 0.13), Qmax (15.9 ± 7.3 mL/s, p < 0.11), and PSA level (1.2 ± 0.8 ng/mL, p < 0.11) were improved compared with the baseline, but the difference was not significant, probably due to the small number of patients evaluated in this period. No patients required a transfusion. Conclusions: The results suggest that PVP with a 940-nm diode laser is safe, effective, and durable for the treatment of LUTS secondary to BPH. The patients continue to be monitored for evaluation of the long-term results. A prospective randomized study would allow more solid conclusions regarding the technology to be reached.

Two Cases of Solitary Fibrous Tumor Involving Urinary Bladder and a Review of the Literature.

Solitary fibrous tumor (SFT) is a rare neoplasia of mesenchymal origin, initially described in visceral pleura and lately discovered to have ubiquitous distribution. SFT of the urogenital tract is uncommon and appears to have similar morphologic features and biologic behaviors as SFTs found elsewhere. We present two new cases of SFT of the bladder and review 22 similar cases published in the literature. Due to the general indolent behavior of these lesions, a complete but organ sparing surgical excision should be considered when technically feasible. Therefore, proper identification and characterization of SFT through morphological and immunohistochemical criteria on biopsy specimens are mandatory in the differential diagnosis from other more aggressive spindle-cell tumors, thus avoiding unnecessary radical surgery.