To evaluate safety, efficacy and clinical outcomes after photovaporization of the prostate with the 180W-XPS Greenlight laser in patients with low urinary tracts symptom secondary to benign prostatic hyperplasia (BPH).
Materials and Methods:
All 102 patients with lower urinary tract symptoms who underwent 180W XPS laser vaporization of the prostate from April 2017 to April 2018 were enrolled. The preoperative parameters, postoperative functional, uroflowmetry outcomes and complications were collected.
Results:
All patients were successfully treated with 180W XPS laser vaporization. Mean preoperative prostate volume was 81±28.7 ml and mean laser time was 28.2±12.5 minutes. No major complications intraoperatively or postoperatively were observed and no blood transfusions were required. Comparing to preoperative characteristics, International Prostate Symptom Score (IPSS), maximum flow rate (Qmax) and post-void residual (PVR) parameters were improved significantly and sustained during the follow-up period. At 3, 6 and 12-month follow-ups, mean urinary peak flow increased from 6.2±2.1 ml per second to 19.8±4.6, 19.4±4.7 and 19.6±4.9 ml per second, respectively. Mean International Prostate Symptom Scores decreased over time, from 28.9±4.5 to 8.2±1.6, 6.2±1.22 and 5.88±1.15 at 3, 6, 12 months, respectively.
Conclusions:
180W XPS Greenlight laser vaporization is a safe and effective treatment option for patients with lower urinary tract symptoms secondary to BPH.
VuichoudC. and LoughlinK.R., Benign prostatic hyperplasia: Epidemiology, economics and evaluation, Can J Urol22(Suppl 1) (2015), 1–6.
2.
American Urological Association Guideline: Management of benign prostatic hyperplasia (BPH). Revised 2010. American Urological Association Education and Research Inc. 2010.
3.
TaoW., SunC.Y., XueB.X., et al., The efficacy and safety of 2-um continuous laser in the treatment of high-risk patients with benign prostatic hyperplasia, Lasers Med Sci32(2) (2017), 351–356.
4.
MalaebB.S., YuX., McBeanA.M., et al., National trends in surgical therapy for benign prostatic hyperplasia in the United States (2000-2008), Urology79 (2012), 1111–1116.
5.
MasumoriN., KamotoT., SekiN., et al., Surgical procedures for benign prostatic hyperplasia: A nationwide survey in Japan, Int J Urol18 (2011), 166–170.
6.
TaoW., XueB., SunC., et al., Comparison of vaporization using 120-W GreenLight laser versus 2-micrometer continuous laser for treating benign prostatic hyperplasia: A 24-month follow-up study of a single center,;, J Xray Sci Technol2019; doi: 10.3233/XST190507.
7.
Ben-zviT., HueberP.A., LibermanD., et al., GreenLight XPS 180W vs HPS 120W Laser Therapy for Benign Prostate Hyperplasia: A Prospective Comparative Analysis After 200 Cases in a Single-center Study, Urology81(4) (2013), 853–858.
8.
HeinrichE., Wendt-NordahlG., HoneckP., et al., 120W lithium triborate laser for photoselective vaporization of the prostate: Comparison with 80W potassium-titanyl-phosphate laser in an ex-vivo model, J Endourol24 (2010), 75–79.
9.
Al-AnsariA., YounesN., SampigeV.P., et al., GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia: A randomized clinical trial with midterm follow-up, Eur Urol58 (2010), 349–355.
10.
CapitanC., BlazquezC., MartinM.D., et al., GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: A randomized clinical trial with 2-year follow-up, Eur Urol60 (2011), 734–739.
11.
HueberP.A., Ben-ZviT., LibermanD., et al., 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, Can J Urol19 (2012), 6450–6458.
12.
TasciA.I., IlbeyY.O., LuleciH., et al., 120-W GreenLight laser photoselective vaporization of prostate for benign prostatic hyperplasia: Midterm outcomes, Urology78 (2011), 134–140.
13.
HueberP.A., LibermanD., Ben-ZviT., et al., 180W vs 120W Lithium Triborate Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia: A Global, Multicenter Comparative Analysis of Perioperative Treatment Parameters, Urology82(5) (2013), 1108–1113.
14.
ZhouJ., TholomierC., ZanatyM., et al., 180W-LBO Greenlight XPS laser vaporization for benign prostatic hyperplasia: Our experience with current markers of surgical proficiency for durable and reproducible outcomes, Can J Urol24(4) (2017), 8922–8931.
15.
CalvesJ., ThoulouzanM., Perrouin-VerbeM.A., et al., Long-term Patient-reported Clinical Outcomes and Reoperation Rate after Photovaporization with the XPS-180W GreenLight Laser,, Eur Urol Focus2017; 11.
16.
PlataM., TrujjlloC.G., DominguezC., et al., Photoselective Vaporization with KTP 180-W Green Laser for the Treatment of Lower Urinary Symptoms Secondary to Benign Prostatic Enlargement: Effectiveness and Safety at Midterm Follow-Up, J Endourol29(11) (2015), 1253–1257.
17.
AjibK., MansourM., ZanatyM., et al., Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser: Five-year experience of safety, efficiency, and functional outcomes, Can Urol J Assoc12(7) (2018), 318–324.
18.
MuirG.G.S., BachmannA., ChoiB., et al., Techniques and training with GreenLight HPS 120-W laser therapy of the prostate: Position paper, Eur Urol Suppl7 (2008), 361–392.
19.
MamoulakisC., EfthimiouI., KazoulisS., et al., The modified Clavien classification system: A standardized platform for reporting complications in transurethral resection of the prostate, World J Urol29(2) (2011), 205–210.
20.
MitropoulosD., ArtibaniW., GraefenM., et al., Reporting and grading of complications after urologic surgical procedures: An ad hoc EAU guidelines panel assessment and recommendations, Eur Urol61(2) (2012), 341–349.
21.
BrunkenC., SeitzC. and WooH., A systematic review of experience of 180W XPS GreenLight laser vaporization of the prostate in 1640 men, BJU Int116(4) (2015), 531–537.
22.
TaoW., XueB.X., ZangY.C., et al., The application of 120-W high-performance system GreenLight laser vaporization of the prostate in high-risk patients, Laser in Medical Science28(4) (2013), 1151–1157.
23.
WooH.H., Photoselective vaporization of the prostate using the 120-W lithium triborate laser in enlarged prostates (>120 cc), BJU Int108 (2011), 860–863.
24.
GuX., VricellaG.J., SpalivieroM., et al., Does size really matter? The impact of prostate volume on the efficacy and safety of GreenLight HPS laser photoselective vaporization of the prostate, J Endourol26 (2012), 525–530.
25.
TasciA.I., IlbeyY.O., LuleciH., et al., 120-W GreenLight laser photoselective vaporization of prostate for benign prostatic hyperplasia: Midterm outcomes, Urology78 (2011), 134–140.
26.
EltermanD.S., How I Do it: Greenlight XPS 180 W photoselective vaporization of the prostate, Can J Urol22(3) (2015), 7836–7843.
27.
BachmannA., TubaroA., BarberN., et al., A European 180-W GreenLight-XPS laser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction: 12-months results of the GOLIATH study, J Urol193(2) (2015), 570–578.
28.
BachmannA., TubaroA., BarberN., et al., 180-W XPS GreenLight laser vaporization versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: 6-month safety and efficacy results of a European Multicenter randomized trial-the GOLIATH study, Eur Urol65(5) (2014), 931–942.
29.
LukacsB., LoefflerJ., BruyereF., et al., Photoselective vaporization of the prostate with GreenLight 120-W laser compared with monopolar transurethral resection of the prostate: A multicenter randomized controlled trial, Eur Urol61 (2012), 1165.
30.
BrunkenC., SeitzC. and WooH.H., A systematic review of experience of 180-W XPS GreenLight laser vaporisation of the prostate in 1640 men, BJU Int116(4) (2015), 531–537.
31.
CastellanP., CastellucciR., SchipsL., et al., Safety, efficacy and reliability of 180-W GreenLight laser technology for prostate vaporization: Review of the literature, World J Urol33(5) (2015), 599–607.
32.
RuszatR., SeitzM., ReichO., et al., GreenLight laser vaporization of the prostate: Single-center experience and long-term results after 500 procedures, Eur Urol54 (2008), 893–901.
33.
HaiM.A., Photoselective vaporization of prostate: Five-year outcomes of entire clinic patient population, Urology73 (2009), 807–810.
34.
Pierre-AlainH., NicolasB.M., et al., Photoselective vaporization of the prostate for benign prostatic hyperplasia using the 180 watt system: A multicenter international study of the impact of prostate size on safety and outcomes, J Urol194 (2015), 1–8.
35.
BachmannA., MuirG., CollinsE., et al., 180-W XPS GreenLight laser therapy for benign prostate hyperplasia: Early safety, efficacy and perioperative outcome after 201 procedures, Eur Urol61 (2012), 600–607.
