To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for benign prostatic obstruction as part of the Clinical Research Office of the Endourological Society Global GreenLight Laser Study.
Data were collected on 713 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction undergoing photoselective vaporization of the prostate at 25 centers worldwide, between April 2010 and April 2012. Three types of GreenLight laser powers were used: 80 W, 120 W or 180 W. Intraoperative and postoperative complications were recorded. Outcome parameters measured at baseline, 6-12 weeks, 6 months and 12 months were: uroflow measurements, International Prostate Symptom Score; prostate-specific antigen and International Index of Erectile Function.
Operating time was shortest with the 180-W laser at 53.8 min. Intraoperatively, bleeding occurred in 3.1% of patients. Statistically significant changes were reported in maximum flow rate, postvoid residual urine, International Prostate Symptom Score, quality of life score and prostate-specific antigen (P < 0.01) at each time-point assessed for the 80- and 120-W lasers as well as for the 180-W laser, with the exception of prostate-specific antigen at 6 months and 12 months. There were 14 Clavien-Dindo grade III-A complications and two grade III-B. The incontinence rate at 12 months was 6.3%, 4.5%, and 2.6% for the 80, 120 and 180 W lasers, respectively. The overall blood transfusion rate was 0.4%.
Objective and subjective improvement after GreenLight laser treatment worldwide was significant at 1-year follow up. Morbidity and complications were low. Although not a randomized control study, the data can provide an indication of the outcome of the different GreenLight laser powers.
International journal of urology : official journal of the Japanese Urological Association 2015 Aug 25 [Epub ahead of print]
Jean de la Rosette, Mostafa Elhilali, Seiji Naito, Dogan Unal, Hassan Razvi, Evangelos Liatsikos, Alexander Bachmann, Andrea Tubaro, Gerasimos Alivizatos, Siu King Mak, Gopal Badlani, Ehab Eltahawy, Carson Wong, Martin Telich Vidal, Alexis Te, Frank d'Ancona, Carl-Jørgen Arum, Jorge Gutierrez, Clinical Research Office of the Endourological Society Global GreenLight Laser Study Group
Department of Urology, AMC University Hospital, Amsterdam, The Netherlands , Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada , Department of Urology, Harasanshin Hospital, Kyushu University, Fukuoka, Japan , Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey , Division of Urology, Department of Surgery, Western University, London, Ontario, Canada , Department of Urology, University of Patras, Rio Patras, Greece , Department of Urology, University Hospital, Basel, Switzerland , Department of Urology, Sant'Andrea Hospital, Rome, Italy , Department of Urology, HYGEIA Hospital, Athens, Greece , Department of Surgery, North District Hospital, Hong Kong, China , Department of Urology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA , Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA , Division of Urology, University Hospitals Ahuja Medical Center, Beachwood, Ohio, USA , Hospital Angeles Del Pedregal, Mexico City, Mexico , Department of Urology, Weill Medical College of Cornell University, New York, New York, USA , Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands , Department of Urology, St Olavs University Hospital, Trondheim, Norway , Department of Urology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA