Multicenter international experience of 532 nm-laser photo-vaporization with Greenlight XPS in men with large prostates (prostate volume > 100 cc)

Abstract

PVP using Greenlight XPS-180W can potentially provide durable improvements with regard to functional outcomes at 4 years. However, rising retreatment rates after 3 years is of concern. This highlights the imperative need of utilizing a standardized surgical technique (enucleation-like-defect) and an optimal energy density >3KJ/cc.

Multicentre international experience of 532‐nm laser photoselective vaporization with GreenLight XPS in men with very large prostates

“…Previous reports have shown bleeding-related conversion to TURP rates in the order of 16%, depending on the prostate size [7,12]. Furthermore, in a recent study, Meskawi et al [5] reported a low rate of TURP conversion of 6% in glands >100 mL. These peri-operative results highlight the most important differences when treating very large glands: time and hospital resources.…”

“…There is evidence in the literature that GreenLight PVP using the XPS 180W system is both safe and feasible, yielding durable functional improvements in experienced hands. As previously shown, GreenLight PVP of prostate glands ≥100 mL in volume is both a safe and durable procedure when using >3-4 kJ/mL of prostate, although it is associated with higher retreatment rates [5,11]. The objective of the present study was to determine the feasibility, safety and durability of GreenLight PVP in patients with very large glands (≥200 mL).…”

“…Furthermore, in a recent study, Meskawi et al. reported a low rate of TURP conversion of 6% in glands >100 mL. These peri‐operative results highlight the most important differences when treating very large glands: time and hospital resources.…”

Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial

“…(3) change in Q max at 3 months; (4) change in PVR at 3 months; (5) change in PSA level at 6 months; (6) preservation of ejaculatory function as measured by a change non-inferior in MSHQ by À4 points at 3 months; (7) preservation of erectile function as measured by a change non-inferior in IIEF-5 score by À6 points at 3 months; (8) re-intervention rate to remove additional prostate tissue at 3 months; and (9) more than half of the patients entering the trial that used a catheter would not be using a catheter at the 3-month visit.…”

Aquablation therapy for symptomatic benign prostatic hyperplasia: a single‐centre experience in 47 patients

“…Five Clavien-Dindo grade I/II and five Clavien-Dindo grade III complications were recorded in eight patients. The mean (range) hospital stay was 3.1 (1)(2)(3)(4)(5)(6)(7)(8) days and the mean (range) duration of urethral catheterization was 1.9 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) days. The mean International Prostate Symptom Score (IPSS) decreased from 24.4 at baseline to 5 at 3 months; IPSS quality-of-life score decreased from 4.5 to 0.3 points; peak urinary flow rate increased from 7.1 to 16.5 mL/s and post-void residual urine volume decreased from 119 to 43 mL (all P < 0.01).…”