Does age affect the efficacy and safety of GreenLight HPS<sup>™</sup>laser photoselective vaporization prostatectomy?

Gu, Xihui; Strom, Kurt H.; Spaliviero, Massimiliano; Wong, Carson

doi:10.3109/13685538.2011.632452

Cited by 12 publications

(19 citation statements)

References 18 publications

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“…Some series comparing older and younger men have found similar clinical efficacy and adverse events. Gu et al, 24 evaluated 164 patients stratified by age. Despite the prostate was bigger in the oldest group (58.7 vs 73.6 mL), IPSS and QoL, Qmax, SHIM, and PVR were similar.…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes and safety of GreenLight photovaporization of the prostate in the high‐risk patient with lower urinary tract symptoms due to benign prostatic enlargement

Barco‐Castillo

Zuluaga

Santander

et al. 2019

Neurourology and Urodynamics

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Aims: Photovaporization of the prostate (PVP) with GreenLight Laser is a surgical treatment for lower urinary tract symptoms. It is considered safe in elderly patients with comorbidities, however, the evidence is inconclusive. The objective of this study is to evaluate the efficacy and safety outcomes of PVP according to the American Society of Anesthesiologists Physical Status (ASAPS). Methods: A cohort of 675 patients who underwent PVP between 2012 and 2018 was evaluated. Patients were classified according to their ASAPS as low (I and II) and high risk (III and IV). Surgical characteristics and improvement of symptoms and Quality of Life (QoL) were evaluated.Results: The median age of high-risk group was higher than low-risk group. The high-risk group had more history of anticoagulation, antiaggregation, urinary catheterization, urinary retention and urethral stricture. Longer times of hospitalization ] vs 21.8 hours , P = .008) and catheterization .57] vs 17.67 hours [IQR = 14.76-22.5], P = .004) were found in the high-risk group. Conversion and bleeding control were not different between groups. In the follow-up

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Section: Discussionmentioning

confidence: 99%

Functional outcomes and safety of GreenLight photovaporization of the prostate in the high‐risk patient with lower urinary tract symptoms due to benign prostatic enlargement

Barco‐Castillo

Zuluaga

Santander

et al. 2019

Neurourology and Urodynamics

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“… 6 , 22–24 Five studies focussed mainly on Holmium laser enucleation of the prostate (HoLEP). 6 , 17 , 20–22 One study focussed on comparing HoLEP to other laser prostatectomy procedures, 16 two studies examined Thulium laser enucleation of the prostate (ThuLEP) in more detail, 14 , 18 and two other studies focussed on the GreenLight XPS 180-W laser procedure, 19 , 23 one focussed on potassium-titanyl-phosphate (KTP) laser 24 and another compared laser prostatectomy to transurethral resection of the prostate (TURP). 15 …”

Section: Resultsmentioning

confidence: 99%

“…They found no significant difference between age groups in terms of perioperative complications. ≥75: 49 N/A N/A 3 (1.4–5.7) 23 (17–27) N/A 4 1 N/A Δ 9 b N/A Gu et al 2012 23 prospective GreenLight HPS™ PVP <70: 93 61.0 ± 6.6 58.7 ± 32 1.9 ± 2.0 23.2 ± 6.3 a 9.4 ± 3.9 4.6 ± 1.1 N/A 30.9 ± 25.3 3.1 ± 1.6 a 20.5 ± 3.8 Significant improvements were observed in American Urological Association Symptom Score (AUASS), QoL, Qmax and PVR compared to baseline values in the 3rd, 6th, 12th, and 36th month controls in both age groups (p< 0.05). There was no significant difference between age groups in terms of these parameters.…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Laser Enucleation of the Prostate in Elderly Patients – A Narrative Review

Yılmaz¹,

Esser²,

Suárez-Ibarrola³

et al. 2022

CIA

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Benign prostatic hyperplasia (BPH) is a common health condition in aging men resulting in lower urinary tract symptoms (LUTS) and low quality of life (QoL). We aimed to review studies on laser enucleation of the prostate (LEP) due to LUTS in elderly patients (>65 years) comparing different age groups, particularly considering functional outcomes, safety, and perioperative complications. A comprehensive search was conducted using the PubMed-MEDLINE, Web of Science, Wiley Online Library and Cochrane Library databases over the last 10 years until 7 October 2021 with the following search terms solely or in combination: “laser enucleation”, “prostate”, “laser prostatectomy”, “aging”, “elderly patients”, “older patients” and “age”. We identified 12 articles for inclusion in our analysis. Five studies focussed mainly on holmium laser enucleation of the prostate (HoLEP), one compared HoLEP to other laser prostatectomy procedures, two studies examined thulium laser enucleation of the prostate (ThuLEP), and two studies focused on GreenLight laser, one study focussed on potassium-titanyl-phosphate (KTP) laser, and another study compared laser prostatectomy to transurethral resection of the prostate (TURP). These studies showed that LEP improved IPSS, Qmax and QoL compared to baseline regardless of age; no significant difference was reported among age groups. Although ASA scores and anticoagulation/antiplatelet therapy rates are higher in elderly patients, studies revealed no significant difference in perioperative complication rates between age groups. Laser enucleation of the prostate is an effective and safe procedure in elderly patients, resulting in good functional outcomes, low morbidity, and few perioperative complications.

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“…previously reported that elderly men (defined as age > 70 years) had similar preoperative and postoperative I-PSS compared to younger men and no differences in the rate of improvement of postoperative LUTS. [ 15 ] Similarly, in a noncomparative case series of octogenarians, Elshal et al . observed that improvements in I-PSS and QOL scores stabilized 1 month after LVP and did not further improve thereafter.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are few data on the safety and efficacy of LVP in elderly men. [ 14 15 ] Therefore, we compared the safety and efficacy of LVP for the treatment of symptomatic BPH in men ≥75 years, who we defined as elderly, to those <75 years.…”

Section: Introductionmentioning

confidence: 99%

Prostate laser vaporization is safe and effective in elderly men

et al. 2015

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Introduction:There are few data on the safety and efficacy of laser photoselective vaporization (LVP) in elderly men. We compared the safety and efficacy of LVP for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men ≥75 years, who we defined as elderly, to those <75 years.Materials and Methods:Safety and efficacy outcomes in elderly men undergoing LVP for lower urinary tract symptoms secondary to BPH from 2005 to 2012 were compared with men <75 years. Differences between-groups in demographics, perioperative outcomes, complications, and postoperative changes in International Prostate Symptom Score (I-PSS) were calculated.Results:Of 202 patients, 49 (24%) were elderly (range: 75-95 years) and 153 (76%) were <75 years. Preoperatively, elderly men were more likely to have heart disease (35% vs. 20%, P = 0.03), gross hematuria (6.1% vs. 0.7%, P = 0.05), urinary retention (57% vs. 41%, P = 0.07), and take anti-coagulants (61% vs. 35%, P = 0.002). Elderly men had a longer median length of stay (1 day vs. 0 day, P = 0.001). There were no significant between-group differences in transfusion frequency (4.4% vs. 0.7%, P = 0.14) or Clavien III complications (2% vs. 2.6%, P = 1.0). One month postsurgery, elderly patients reported smaller median decreases in I-PSS (5.5 vs. 9, P = 0.02) and urinary bother (1 point vs. 2, P = 0.03) compared with preoperative values. At till 9 months follow-up, there were no significant between-group differences in median I-PSS or urinary bother scores.Conclusions:Despite a higher prevalence of preoperative comorbidity and urinary retention, elderly LVP patients experienced perioperative safety and shorter term efficacy outcomes comparable to younger men.

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Does age affect the efficacy and safety of GreenLight HPS^™laser photoselective vaporization prostatectomy?

Abstract: The results suggest that age has little effect on the efficacy and safety of GreenLight HPS™ laser PVP.

Cited by 12 publications

References 18 publications

Functional outcomes and safety of GreenLight photovaporization of the prostate in the high‐risk patient with lower urinary tract symptoms due to benign prostatic enlargement

Functional outcomes and safety of GreenLight photovaporization of the prostate in the high‐risk patient with lower urinary tract symptoms due to benign prostatic enlargement

Safety and Efficacy of Laser Enucleation of the Prostate in Elderly Patients – A Narrative Review

Prostate laser vaporization is safe and effective in elderly men

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Does age affect the efficacy and safety of GreenLight HPS™laser photoselective vaporization prostatectomy?

Abstract: The results suggest that age has little effect on the efficacy and safety of GreenLight HPS™ laser PVP.

Cited by 12 publications

References 18 publications

Functional outcomes and safety of GreenLight photovaporization of the prostate in the high‐risk patient with lower urinary tract symptoms due to benign prostatic enlargement

Functional outcomes and safety of GreenLight photovaporization of the prostate in the high‐risk patient with lower urinary tract symptoms due to benign prostatic enlargement

Safety and Efficacy of Laser Enucleation of the Prostate in Elderly Patients – A Narrative Review

Prostate laser vaporization is safe and effective in elderly men

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Does age affect the efficacy and safety of GreenLight HPS^™laser photoselective vaporization prostatectomy?