Mid term outcomes of initial 250 case experience with Greenlight 120W-HPS photoselective vaporization prostatectomy for benign prostatic hyperplasia: Comparison of prostate volumes < 60 cc, 60 cc-100 cc and > 100 cc

Pierre Alain Hueber, Tal Ben-Zvi, Daniel Liberman, Naeem Bhojani, Gagan Gautam, Tom Deklaj, Mark Katz, Kevin C. Zorn

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Introduction: The aim of this study was to compare the efficacy of GreenLight 120-HPS (American Medical Systems, Minnetonka, Minnesota, USA) laser vaporization for men with obstructive benign prostatic hyperplasia (BPH) according to prostate volumes < 60 cc, 60 cc-100 cc and > 100 cc. Material and methods: The clinical data of 250 men with symptomatic BPH who underwent photoselective vaporization prostatectomy (PVP) by a single surgeon between July 2007 and August 2009 were retrospectively analyzed. Prostate volumes were measured by using transrectal ultrasonography (TRUS). Functional evaluations were performed at 3, 6 and 12 months with a prostate-specific antigen (PSA) obtained at 6 months. All men were stratified into three groups according to TRUS volume. Results: Among the 250 consecutive PVP patients, 134, 76 and 40 men had prostate volumes < 60 cc, 60 cc-100 cc and > 100 cc, respectively. Mean laser time and delivered energy were 31, 44 and 59 minutes; 163, 309 and 473kJ respectively (p < 0.01 for all). At 1 year, mean International Prostate Symptom Score (IPSS) improved by 69%, 63% and 50%, Qmax increased by 194%, 175% and 162% and post void residual (PVR) decreased by 88%, 81% and 71%, respectively (p < 0.01 for all). Mean decrease in preoperative PSA at 6 months was 63%, 52% and 41% (p < 0.01), respectively. Hospital stay, catheterization time and complication rates were comparable between groups, however retreatment rates were significantly higher for prostates >100 cc (1.5% versus 2.6% versus 9%; p = 0.02). Conclusions: Although larger prostates require more time and energy delivery, PVP is safe and efficacious for patients with lower urinary tract symptoms (LUTS) regardless of prostate size. Laser vaporization for glands > 100 cc appears to have a reduced reduction in PSA and a higher 9% rate of retreatment indicating that PVP for larger prostates remains to be optimized.

Original languageEnglish (US)
Pages (from-to)6450-6458
Number of pages9
JournalCanadian Journal of Urology
Volume19
Issue number5
StatePublished - Oct 1 2012

Keywords

  • GreenLight 120W-HPS
  • Laser photoselective vaporization
  • Prostate size
  • Prostatectomy

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