The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature

doi:10.1016/j.ajur.2019.01.006

Asian Journal of Urology, 2019, 6 (4): 353-358 doi: 10.1016/j.ajur.2019.01.006

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The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature

Dominique Thomas^a,1,Kevin C. Zorn^b,1,Malek Meskawi^b,Ramy Goueli^a,Pierre-Alain Hueber^b,Lesa Deonarine^a,Vincent Misrai^b,Alexis Te^a,Bilal Chughtai^a,*(

)

^a Department of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA
^b Section of Urology, Department of Surgery, University of Montreal Hospital Center, Montreal, QC, Canada

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Abstract

Objective: Our objective was to characterize the safety and efficacy of the 180 W XPS-GreenLight laser in men with lower urinary tract symptoms secondary to a small volume benign prostatic hyperplasia (BPH). Methods: A retrospective analysis was performed for all patients who underwent 180 W XPS-laser photoselective vaporization of the prostate (PVP) vaporization of the prostate between 2012 and 2016 at two-tertiary medical centers. Data collection included baseline comorbidities, disease-specific quality of life scores, maximum urinary flow rate (Q_max), postvoid residual (PVR), complications, prostate volume and prostate-specific antigen (PSA). The secondary endpoints were the incidence of intraoperative and postoperative adverse events. Complications were stratified using the Clavien-Dindo grading system up to 90 days after surgery. Results: Mean age of men was 67.8 years old, with a mean body mass index of 29.7 kg/m ². Mean prostate volume as measured by transrectal ultrasound was 29 mL. Anticoagulation use was 47% and urinary retention with catheter at time of surgery was 17%. Mean hospital stay and catheter time were 0.5 days. Median follow-up time was 6 months with the longest duration of follow-up being 22.5 months (interquartile range, 3-22.5 months). The International Prostate Symptom Score improved from 22.8 ± 7.0 at baseline to 10.7 ± 7.4 (p < 0.01) and 6.3 ± 4.4 (p < 0.01) at 1 and 6 months, respectively. The Q_max improved from 7.70 ± 4.46 mL/s at baseline to 17.25 ± 9.30 mL/s (p < 0.01) and 19.14 ± 7.19 mL/s (p < 0.001) at 1 and 6 months, respectively, while the PVR improved from 216.0 ± 271.0 mL preoperatively to 32.8 ± 45.3 mL (p < 0.01) and 26.2 ± 46.0 mL (p < 0.01) at 1 and 6 months, respectively. The PSA dropped from 1.97 ± 1.76 ng/mL preoperatively to 0.71 ± 0.61 ng/mL (p < 0.01) and 0.74 ± 0.63 ng/mL at 1 and 6 months, respectively. No patient had a bladder neck contracture postoperatively and no capsular perforations were noted intraoperatively. Conclusion: The 180 W GreenLight XPS system is safe and effective for men with small volume BPH. PVP produced improvements in symptomatic and clinical parameters without any safety concern. It represents a safe surgical option in this under studied population.

Key words： Benign prostatic hyperplasia Photovaporization of the prostate GreenLight XPS Lower urinary tract symptoms Small prostate

Received: 24 April 2018 Available online: 25 January 2019

Corresponding Authors: Bilal Chughtai E-mail: bic9008@med.cornell.edu

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	Articles by authors
	Dominique Thomas
	Kevin C. Zorn
	Malek Meskawi
	Ramy Goueli
	Pierre-Alain Hueber
	Lesa Deonarine
	Vincent Misrai
	Alexis Te
	Bilal Chughtai

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Cite this article:

Dominique Thomas,Kevin C. Zorn,Malek Meskawi, et al. The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature[J]. Asian Journal of Urology, 2019, 6(4): 353-358.

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http://www.ajurology.com/EN/10.1016/j.ajur.2019.01.006 OR http://www.ajurology.com/EN/Y2019/V6/I4/353

Descriptive characteristics of 58 patients treated with XPS GreenLight for small prostate size (prostate volume ≤40 mL).

Operative characteristics of 58 patients treated with XPS GreenLight for small prostate size (prostate volume ≤40 mL).

Postoperative adverse events of patients treated with XPS GreenLight for small prostate size (prostate volume ≤40 mL).

Postoperative outcomes following photovaporization of the prostate.

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