Objective: Photoselective vaporization of the prostate (PVP) is becoming a surgical treatment alternative of transurethral resection of the prostate for male lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO). We evaluated the outcome and postoperative complications of PVP performed by 80-W KTP and 120-W HPS GreenLight lasers (AMS®) over a 4-year period. Materials and Methods: This is a prospective monocentric study that included all patients who underwent PVP. They had routine follow-up at 1 month, 3 months, 6 months and every year until the fourth postoperative year. Listed data were maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), post-void residual (PVR) volume, prostate-specific antigen (PSA) and prostate volume. We collected the postoperative complications. Results: From September 2005 to May 2008, 77 patients out of a 409 patients cohort underwent surgery and were followed during 4 years. At 4 years mean Qmax increase was 82.5%; mean IPSS, PVR volume, PSA and prostate volume decreases were 79.1, 69.8, 43.8 and 22.9%, respectively. The main side effects observed were storage LUTS. A urinary catheter was replaced after a first withdrawal failure in 10 patients (15.6%) after surgery. Conclusions: PVP showed a sustainable efficacy and an appealing tolerance profile during a 4-year period in patients with LUTS secondary to BPO.

Keywords:
Prostate photovaporization, Prostate laser, Benign prostatic obstruction, GreenLight laser
1.
Thangasamy IA, Chalasani V, Bachmann A, Woo HH: Photoselective vaporisation of the prostate using 80-W and 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis from 2002 to 2012. Eur Urol 2012;62:315-323.
2.
Lukacs B, Loeffler J, Bruyère F, Blanchet P, Gelet A, Coloby P, De la Taille A, Lemaire P, Baron JC, Cornu JN, Aout M, Rousseau H, Vicaut E; REVAPRO Study Group: Photoselective vaporization of the prostate with GreenLight 120-W laser compared with monopolar transurethral resection of the prostate: a multicenter randomized controlled trial. Eur Urol 2012;61:1165-1173.
3.
Bachmann A, Muir GH, Collins EJ, Choi BB, Tabatabaei S, Reich OM, Gómez-Sancha F, Woo HH: 180-W XPS GreenLight laser therapy for benign prostate hyperplasia: early safety, efficacy, and perioperative outcome after 201 procedures. Eur Urol 2012;61:600-607.
4.
Al-Ansari A, Younes N, Sampige VP, Al-Rumaihi K, Ghafouri A, Gul T, Shokeir AA: 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 Urol 2010;58:349-355.
5.
Pereira-Correia JA, de Moraes Sousa KD, Santos JB, de Morais Perpétuo D, Lopes-da-Silva LF, Krambeck RL, Muller VJ, Vaz FP: GreenLight HPS™ 120-W laser vaporization vs transurethral resection of the prostate (<60 ml): a 2-year randomized double-blind prospective urodynamic investigation. BJU Int 2012;110:1184-1189.
6.
Descazeaud A, Robert G, Azzousi AR, Ballereau C, Lukacs B, Haillot O, Dumonceau O, Devonec M, Fourmarier M, Saussine C, de la Taille A; Committee for lower urinary tract symptoms of the French Association of Urology: Laser treatment of benign prostatic hyperplasia in patients on oral anticoagulant therapy: a review. BJU Int 2009;103:1162-1165.
7.
Ruszat R, Wyler S, Forster T, Reich O, Stief CG, Gasser TC, Sulser T, Bachmann A: Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol 2007;51:1031-1038; discussion 1038-1041.
8.
Sandhu JS, Ng CK, Gonzalez RR, Kaplan SA, Te AE: Photoselective laser vaporization prostatectomy in men receiving anticoagulants. J Endourol 2005;19:1196-1198.
9.
Tanchoux C, Pereira H, Brichart N, Bruyère F: Perioperative and early postoperative results of photoselective vaporization of the prostate using fiber 4090 (providing 120 watts) versus fiber MOXY (providing 180 watts). Prog Urol 2012;22:529-533.
10.
Bouchier-Hayes DM, Van Appledorn S, Bugeja P, Crowe H, Challacombe B, Costello AJ: A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up. BJU Int 2010;105:964-969.
11.
Capitán C, Blázquez C, Martin MD, Hernández V, de la Peña E, Llorente C: 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 Urol 2011;60:734-739.
12.
Ruszat R, Seitz M, Wyler SF, Abe C, Rieken M, Reich O, Gasser TC, Bachmann A: GreenLight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures. Eur Urol 2008;54:893-901.
13.
Kang SH, Choi YS, Kim SJ, Cho HJ, Hong SH, Lee JY, Hwang TK, Kim SW: Long-term follow-up results of photoselective vaporization of the prostate with the 120 W GreenLight HPS laser for treatment of benign prostatic hyperplasia. Korean J Urol 2011;52:260-264.
14.
Horasanli K, Silay MS, Altay B, Tanriverdi O, Sarica K, Miroglu C: Photoselective potassium titanyl phosphate (KTP) laser vaporization versus transurethral resection of the prostate for prostates larger than 70 ml: a short-term prospective randomized trial. Urology 2008;71:247-251.
15.
Bachmann A, Schürch L, Ruszat R, Wyler SF, Seifert HH, Müller A, Lehmann K, Sulser T: Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 2005;48:965-971; discussion 972.
16.
Volkan T, Ihsan TA, Yilmaz O, Emin O, Selcuk S, Koray K, Bedi O: Short term outcomes of high power (80 W) potassium-titanyl-phosphate laser vaporization of the prostate. Eur Urol 2005;48:608-613.
17.
Malek RS, Kuntzman RS, Barrett DM: Photoselective potassium-titanyl-phosphate laser vaporization of the benign obstructive prostate: observations on long-term outcomes. J Urol 2005;174:1344-1348.
18.
Bruyère F, Sotto A, Escaravage L, Cariou G, Mignard JP, Coloby P, Hoznek A, Bernard L, Boiteux JP, Thibault M, Soussy CJ, Bugel H; Infectious Disease Committee of the French Association of Urology (AFU): Recommendations of the Infectious Disease Committee of the French Association of Urology (AFU): antibiotic prophylaxis for urological procedures. Prog Urol 2010;20:101-108.
19.
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A; Standardisation Sub-committee of the International Continence Society: The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167-178.
20.
Bachmann A, Ruszat R, Wyler S, Reich O, Seifert HH, Müller A, Sulser T: Photoselective vaporization of the prostate: the basel experience after 108 procedures. Eur Urol 2005;47:798-804.
21.
Tao W, Xue B, Zang Y, Sun C, Yang D, Zhang Y, Shan Y: The application of 120-W high-performance system GreenLight laser vaporization of the prostate in high-risk patients. Lasers Med Sci 2013;28:1151-1157.
22.
Rassweiler J, Teber D, Kuntz R, Hofmann R: Complications of transurethral resection of the prostate (TURP) - incidence, management, and prevention. Eur Urol 2006;50:969-979; discussion 980.
23.
Vinceneux FX, Thebault B, Bruyère F: Urgency rate after prostate photoselective vaporization depends on the definition we use. Prog Urol 2011;21:724.
24.
Hai MA: Photoselective vaporization of prostate: five-year outcomes of entire clinic patient population. Urology 2009;73:807-810.
25.
Hermanns T, Sulser T, Fatzer M, Baumgartner MK, Rey JM, Sigrist MW, Seifert HH: Laser fibre deterioration and loss of power output during photo-selective 80-w potassium-titanyl-phosphate laser vaporisation of the prostate. Eur Urol 2009;55:679-685.
26.
Madersbacher S, Lackner J, Brössner C, Röhlich M, Stancik I, Willinger M, Schatzl G; Prostate Study Group of the Austrian Society of Urology: Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: a nation-wide, long-term analysis of 23,123 cases. Eur Urol 2005;47:499-504.
© 2014 S. Karger AG, Basel
2014
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