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GREEN LIGHT PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE: ONE LASER FOR DIFFERENT PROSTATE SIZES
摘要： INTRODUCTION GreenLight laser vaporization of the prostate (PVP) is a safe and effective procedure for Benign Prostatic Hyperplasia. Long term results and advantages of PVP in patients with large and symptomatic prostate are still under evaluation. MATERIALS AND METHODS In a multicenter experience, patients who underwent standard or anatomical PVP were retrospectively reviewed. Patients with follow-up >12 months were divided into two groups based on prostate volume (<100cc vs ≥100cc). Pre- and peri-operative data as well as post-operative results and complications were recorded after 3, 6, 12 months and then annually. RESULTS 1031 patients were eligible, 916 of these had a prostate volume of <100 cc and 115 ≥100 cc. Median follow-up period was 25.0 months (IQR 16.5-35.0) and 16.0 months (IQR 12.0-24.0) in ≥100 and <100 groups, respectively. No difference was found in terms of catheterization time, post-operative stay and post-operative acute urine retention. Patients with prostate ≥100 required longer operative time (75 versus 55 minutes), lasing time (41.7 versus 24.9 minutes), and higher energy used but lower energy density. Patients with prostate ≥100 had a higher incidence of early (50.4 versus 35.7%) and late complications (21.7 versus 12.8%) and early urge/incontinence symptoms (40.9 versus 29.3%). No statistically significant differences were found for the Qmax and IPSS results between the two groups. The re-intervention rate in ≥100 group was 3.5% versus 2.3% in <100. CONCLUSIONS In the midterm follow-up, Greenlight PVP guarantees the same results in different prostate volumes groups. Early and late complications are more frequent in large prostates.
关键词： complications,photoselective vaporization of the prostate,prostate volume,benign prostatic hyperplasia,GreenLight laser
更新于2025-09-23 15:19:57
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Optimising patient outcomes with photoselective vaporization of the prostate (PVP): a review
摘要： Benign prostatic hyperplasia (BPH) is a common pathology causing lower urinary tract symptoms (LUTS) and may significantly impact quality of life. While transurethral resection of the prostate (TURP) remains the gold standard treatment, there are many evolving technologies that are gaining popularity. Photoselective vaporization of the prostate (PVP) is one such therapy which has been shown to be non-inferior to TURP. We aimed to review the literature and discuss factors to optimise patient outcomes in the setting of PVP for BPH. A comprehensive search of the electronic databases, including MEDLINE, Embase, Web of Science and The Cochrane Library was performed on articles published after the year 2000. After exclusion, a total of 38 papers were included for review. The evolution of higher powered device has enabled men with larger prostates and those on oral anticoagulation to undergo safely and successfully PVP. Despite continued oral anticoagulation in patients undergoing PVP, the risk of bleeding may be minimised with 5-Alpha Reductase Inhibitor (5-ARI) therapy however further studies are required. Pre-treatment with 5-ARI’s does not hinder the procedure however more studies are required to demonstrate a reliable benefit. Current data suggests that success and complication rate is largely influenced by the experience of the operator. Post-operative erectile dysfunction is reported in patients with previously normal function following PVP, however those with a degree of erectile dysfunction pre-operatively may see improvement with alleviation of LUTS.
关键词： sexual function,outcomes,urinary function,Benign prostatic hyperplasia (BPH),prostate,photoselective vaporization of the prostate (PVP)
更新于2025-09-19 17:15:36
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Comparison of photoselective green light laser vaporisation versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta-analysis of randomised controlled trials and prospective studies
摘要： Objective To assess the efficacy and safety of green-light laser photoselective vaporisation of the prostate (PVP) compared with transurethral resection of the prostate (TURP) for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Design Systematic review and meta-analysis, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Data sources PubMed, EMBASE, the Cochrane Library until October 2018. Eligibility criteria Randomised controlled trials and prospective studies comparing the safety and efficacy of PVP versus TURP for LUTS manifesting through BPH. Data extraction and synthesis Perioperative parameters, complications rates and functional outcomes including treatment-related adverse events such as International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), postvoid residual (PVR), quality of life (QoL) and International Index of Erectile Function (IIEF). results 22 publications consisting of 2665 patients were analysed. Pooled analysis revealed PVP is associated with reduced blood loss, transfusion, clot retention, TUR syndrome, capsular perforation, catheterisation time and hospitalisation, but also with a higher reintervention rate and longer intervention duration (all p<0.05). No significant difference in IPSS, Qmax, QoL, PVR or IIEF at 3, 24, 36 or 60 months was identified. There was a significant difference in QoL at 6 months (MD=?0.08; 95% CI ?0.13 to ?0.02; p=0.007), and IPSS (MD = ?0.10; 95% CI ?0.15 to ?0.05; p<0.0001) and Qmax (MD=0.62; 95% CI 0.06 to 1.19; p=0.03) at 12 months, although these differences were not clinically relevant. Conclusion PVP is an effective alternative, holding additional safety benefits. PVP has equivalent long-term IPSS, Qmax, QoL, PVR, IIEF efficacy and fewer complications. The main drawbacks are dysuria and reintervention, although both can be managed with non-invasive techniques. The additional shortcoming is that PVP does not acquire histological tissue examination which removes an opportunity to identify prostate cancer.
关键词： PVP,transurethral resection of the prostate,benign prostatic hyperplasia,photoselective vaporization of the prostate,BPH,green-light laser,vaporization,TURP
更新于2025-09-19 17:13:59
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Is Greenlight laser photoselective vaporization of the prostate a safe technique? Results from a wide monocentric series complications analysis, with a focus on postoperative fever and sepsis
摘要： GreenLight laser Photoselective Vaporization of the Prostate (PVP) is an effective surgical treatment for Benign Prostatic Hyperplasia (BPH). Moreover, its high coagulative power makes GreenLight reliable in high-risk patients (pts). Despite this, post-operative complications still represent a source of concern when surgery is performed in the most fragile pts. The aim of our study was to retrospectively review a large cohort of pts underwent GreenLight PVP and perform a complications analysis, with a focus on post-operative fever and sepsis.
关键词： sepsis,Benign Prostatic Hyperplasia,postoperative complications,Photoselective Vaporization of the Prostate,GreenLight laser,fever
更新于2025-09-19 17:13:59