The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature
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-las...
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Elsevier
2019-10-01
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| Series: | Asian Journal of Urology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388219300074 |
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| author | Dominique Thomas Kevin C. Zorn Malek Meskawi Ramy Goueli Pierre-Alain Hueber Lesa Deonarine Vincent Misrai Alexis Te Bilal Chughtai |
| author_facet | Dominique Thomas Kevin C. Zorn Malek Meskawi Ramy Goueli Pierre-Alain Hueber Lesa Deonarine Vincent Misrai Alexis Te Bilal Chughtai |
| author_sort | Dominique Thomas |
| collection | DOAJ |
| description | 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 (Qmax), 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/m2. 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 Qmax 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. Keywords: Benign prostatic hyperplasia, Photovaporization of the prostate, GreenLight XPS, Lower urinary tract symptoms, Small prostate |
| format | Article |
| id | doaj-art-5020d98566b4431dbba731ab843f2d99 |
| institution | Kabale University |
| issn | 2214-3882 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | Elsevier |
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| series | Asian Journal of Urology |
| spelling | doaj-art-5020d98566b4431dbba731ab843f2d992025-08-20T03:48:41ZengElsevierAsian Journal of Urology2214-38822019-10-016435335810.1016/j.ajur.2019.01.006The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literatureDominique Thomas0Kevin C. Zorn1Malek Meskawi2Ramy Goueli3Pierre-Alain Hueber4Lesa Deonarine5Vincent Misrai6Alexis Te7Bilal Chughtai8Department of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USASection of Urology, Department of Surgery, University of Montreal Hospital Center, Montreal, QC, CanadaSection of Urology, Department of Surgery, University of Montreal Hospital Center, Montreal, QC, CanadaDepartment of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USASection of Urology, Department of Surgery, University of Montreal Hospital Center, Montreal, QC, CanadaDepartment of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USASection of Urology, Department of Surgery, University of Montreal Hospital Center, Montreal, QC, CanadaDepartment of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USADepartment of Urology, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA; Corresponding author.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 (Qmax), 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/m2. 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 Qmax 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. Keywords: Benign prostatic hyperplasia, Photovaporization of the prostate, GreenLight XPS, Lower urinary tract symptoms, Small prostatehttp://www.sciencedirect.com/science/article/pii/S2214388219300074 |
| spellingShingle | Dominique Thomas Kevin C. Zorn Malek Meskawi Ramy Goueli Pierre-Alain Hueber Lesa Deonarine Vincent Misrai Alexis Te Bilal Chughtai The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature Asian Journal of Urology |
| title | The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature |
| title_full | The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature |
| title_fullStr | The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature |
| title_full_unstemmed | The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature |
| title_short | The role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature |
| title_sort | role of photovaporization of the prostate in small volume benign prostatic hyperplasia and review of the literature |
| url | http://www.sciencedirect.com/science/article/pii/S2214388219300074 |
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