Efficacy and Safety of Photoselective Vaporization of the Prostate with 120 W 532 nm Laser in Patients with Benign Prostatic Hyperplasia on Anticoagulation or Antiplatelet Therapy: Observations on Long-Term Outcomes

Abstract

Our results demonstrate that PVP for patients with BPH is an effective and safe procedure with satisfactory long-term outcomes. Anticoagulant and antiplatelet drugs did not significantly influence the results, or the complication rates.

Expression of Concern: Benign prostatic hyperplasia wound after surgical removal in subjects on anticoagulant or antiplatelet therapy: A meta‐analysis

“…A total of 3450 distinctive studies were found, of which 19 studies (between 1996 and 2021) satisfied the inclusion criteria and were comprised in the study. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] This metaanalysis study based on 19 studies included 5715 benign prostatic hyperplasia subjects at the start of the study; 1501 of them were on anticoagulant/antiplatelet therapy, and 4214 were control. All studies evaluated the safety of benign prostatic hyperplasia wound after surgical removal in subjects on anticoagulant or antiplatelet therapy.…”

“…A total of 3450 distinctive studies were found, of which 19 studies (between 1996 and 2021) satisfied the inclusion criteria and were comprised in the study 10‐28 . This meta‐analysis study based on 19 studies included 5715 benign prostatic hyperplasia subjects at the start of the study; 1501 of them were on anticoagulant/antiplatelet therapy, and 4214 were control.…”

“…This meta-analysis study constructed on 19 studies included 5715 benign prostatic hyperplasia subjects at the start of the study; 1501 of them were on anticoagulant/ antiplatelet therapy, and 4214 were control [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Anticoagulant/antiplatelet therapy had a significantly higher bleeding complication, higher blood transfusion, lower operation time, higher catheterization time, longer length of hospital stay and higher thromboembolic events compared to control in benign prostatic hyperplasia subjects. However, the analysis of outcomes should be performed with consideration because of the low sample size of some of the selected studies found for the meta-analysis, 6 out of 19 studies with ≤100 subjects as sample size; recommending the need for other studies to confirm these findings or perhaps to significantly impact confidence in the influence evaluation.…”

Performing 180-Watt GreenLight® Laser Prostatectomy using Periprostatic Block

“…Although the feasibility of using local anesthesia during 80-Watt PVP has been previously evaluated [6] , there are no such data for 180-Watt PVP. The fibers used in this new system are water cooled, which reduces laser energy in case of overheating [14,15] . This technology may explain the more favorable outcome of pain recorded for our patients compared with those in previous studies, in which prostatic block was used for transurethral prostate procedures.…”

Development of Medical Lasers for Treatment on Benign Prostatic Hyperplasia

“…[ 17 ] The hemostasis of green lasers is excellent, which allows PVP appling to patients of BPH with anticoagulant therapy. [ 18 ] PVP also applies to large-volume prostate patients. A study was performed to evaluate the results of GreenLight XPS photovaporization (PVP/XPS) with intraoperative transrectal ultrasonographic monitoring for the treatment of large BPH, with volume >80 ml.…”