Operative profile, safety and functional outcomes after GreenLight laser prostate surgery: results from a 12 months follow-up multicenter Italian cohort analyses

Reale, Giulio; Marchioni, Michele; Altieri, Vincenzo; Greco, Francesco; Nunzio, Cosimo De; Destefanis, Paolo; Ricciardulli, S.; Bergamaschi, F.; Fasolis, Giuseppe; Varvello, Francesco; Voce, S.; Palmieri, Fabiano; Divan, C.; Malossini, G.; Oriti, Rino; Tuccio, Agostino; Ruggera, Lorenzo; Tubaro, Andrea; Delicato, Giampaolo; Laganà, Antonino; Dadone, C.; Rienzo, Gaetano De; Ditonno, Andrea; Frattini, Antonio; Pucci, Luigi; Carrino, Maurizio; Montefiore, F.; Germani, Stefano; Miano, Roberto; Schips, Luigi; Rabito, Salvatore; Ferrari, Giovanni; Cindolo, Luca

doi:10.23736/s0393-2249.20.03597-3

Cited by 13 publications

(5 citation statements)

References 14 publications

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“…This study is not devoid of limitations. Although prospective in nature, it is a longitudinal cohort study with no control arm [25]. At present, there is a lack of data on long-term follow-up and the need for repeat or alternate procedures is unknown.…”

Section: Discussionmentioning

confidence: 99%

Water vapor therapy (Rezūm) for lower urinary tract symptoms related to benign prostatic hyperplasia: early results from the first Italian multicentric study

et al. 2021

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Purpose Rezūm is the latest developed minimally invasive treatment for benign prostatic hyperplasia (BPH). We aimed to carefully assess the functional outcomes of patients treated with Rezūm for BPH. Methods We prospectively followed 135 consecutive patients treated by Rezūm at 5 institutions from June 2019 to August 2020. The International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), the Overactive Bladder Questionnaire-Short Form (OAB-q SF) score, the International Index of Erectile Function (IIEF-5) and questions 9 and 10 to assess ejaculatory dysfunction were recorded. Election criteria were age > 18, no prior prostate interventions, IPSS ≥ 13, post-void residual ≤ 250 mL, prostate volume between 30 and 120 cc. Results The median operative time was 10.5 (IQR 8.7–15) min. All patients were dismissed few hours after surgery with indwelling urinary catheter that was removed after a median of 7 (IQR 7–10) days. A significantly decrease of IPSS from baseline at first ( p = 0.001) and third ( p < 0.0001) month after surgery was reported. No difference was reported in terms of ICIQ-UI SF score postoperatively. A mild reduction of the OAB-q SF score was reported at 1 month from surgery ( p = 0.06) that turned significant at 3 months postoperatively ( p < 0.0001). A slight but statistically significant increase of the IIEF-5 score was reported from baseline at 6 months ( p = 0.04). Postoperatively, patients reported a significantly decrease of ejaculatory dysfunction after alpha-blocker interruption. Conclusion Rezūm treatment is a feasible minimally invasive option for patients with BPH symptoms and showed optimal early functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Water vapor therapy (Rezūm) for lower urinary tract symptoms related to benign prostatic hyperplasia: early results from the first Italian multicentric study

et al. 2021

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“…Driven by the desire to offer the patient a resolution of symptoms comparable to the surgical gold standard TURP while exposing them to a lower risk of side effects, urologists have provided several alternative surgical techniques over the years. Laser enucleation, photovaporization, and water ablation of the prostate are widely used endoscopic techniques, but they have been shown to produce non-negligible complication rates [10][11][12][13][14][15]. For this reason, in recent years the scientific community has turned its interest more toward the so-called minimally invasive techniques, including iTIND.…”

Section: Discussionmentioning

confidence: 99%

“…The authors showed a significant change from baseline in IPSS, IPSS QoL score, and Qmax at every follow-up time point. In fact, at 36-month follow-up, the recorded Qmax value was 41% above baseline, median IPSS was 12 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), and median IPSS QoL was 2 (1-4).…”

Section: Tindmentioning

confidence: 95%

“…In the last decades, various other surgical options have been proposed in clinical practice with the aim to minimize the risk of surgical complications in comparison with standard techniques, while producing a symptom's relief higher than oral medications. Endoscopic techniques such as laser enucleation, photo-vaporization, and water ablation of the prostate have demonstrated great efficacy, but have been shown to have not negligible rates of complications [9][10][11][12][13][14][15][16]. On the other hand, MIS does not seem to be burdened by a significant rate of AEs compared to TURP [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Functional Results after First- and Second-Generation Temporary Implantable Nitinol Device (TIND) for BPH: A Narrative Review of the Literature

Cillis

Volpi

Checcucci

et al. 2022

Curr Bladder Dysfunct Rep

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Purpose of review In the last decades, new promising technologies for the treatment of BPH-related lower urinary tract symptoms (LUTS) have been widely experienced in clinical practice, with the aim of offering fewer complications but similar functional outcomes compared with the gold standard transurethral resection of the prostate (TURP). Among these so-called minimally invasive approaches, transurethral implantation of first- and second-generation temporary implantable nitinol device (TIND and iTIND, respectively) (Medi-Tate; Medi-Tate Ltd., Or Akiva, Israel) has been included by the European Association of Urology (EAU) Guidelines as one of the available alternative treatments to TURP. In the present paper, we conducted a systematic review of the current literature on TIND and iTIND implantation focusing on functional outcomes. Medline, Embase, and Cochrane databases were queried for relevant Literature in May 2021. Recent findings Data regarding the use of temporary implantable nitinol device for BPH are still very limited, with only seven studies currently available in Literature. All the studies report that both TIND and iTIND procedures are safe, effective, and well tolerated. Moreover, such treatments seem to not affect patient’s sexual and ejaculatory functions. Summary Current clinical evidence suggests that temporary implantation of first- and second-generation temporary implantable nitinol devices are valid options for the minimally invasive surgical treatment of BPH-related LUTS. Further studies are required in order to confirm the functional results, especially over a long-term follow up.

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“…For all those reasons, in the last few decades, a tremendous effort has been made by urologists in the search for new surgical techniques to improve upon the results achieved by TURP. The impressive momentum of innovation driven by the availability of new technologies has supplied the surgical armamentarium with plenty of new techniques using different types of energy, such as lasers (Holmium, Thullim, photoselective vaporization (PVP)), water vapor thermal therapy (Rezum), temporary implantable nitinol devices (iTINDs) and prostatic urethral lift (PUL) (7)(8)(9)(10)(11)(12), among others. Besides the proven safety and feasibility, the occurrence or persistence of filling phase symptoms is still an open issue.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of LUTS of the filling phase after Aquablation: A prospective single center experience

et al. 2022

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IntroductionThis study aims to assess our first clinical experience with Aquablation in terms of perioperative and 1-year micturition outcomes, with a focus on postoperative lower urinary tract symptoms (LUTS).Materials and methodsFrom 10/2018 to 07/2021, patients referred to our center with BPH-related LUTS, International Prostate Symptom Score (IPSS) ≥10, maximum urinary flow rate (Qmax) ≤12 ml/s, and prostate volume <80 ml were enrolled in this prospective study to undergo Aquablation. Demographics, perioperative data, and complications (according to the Clavien–Dindo system) were collected. Functional outcomes were assessed at 1, 3, 6, and 12 months with IPSS, IPSS quality of life (IPSS QoL), uroflowmetry, and evaluation of post void residue (PVR). The types of LUTS were classified on the basis of IPSS single question answers in filling phase LUTS and voiding phase LUTS.ResultsSixty patients were enrolled in the study. The mean patient age was 64.9 ± 7.3 years, prostate volume was 63.5 ± 16.8) ml, Qmax was 8.4 ± 2.6 ml/s, the median (IQR) IPSS was 23 (19–26), and the IPSS QoL score was 5 (4–5). The mean Qmax at 1, 3, 6, and 12 months was 21.1 ± 11, 18.1 ± 5.4, 17.1 ± 6, and 17.8 ± 6.6 ml/s, respectively. The median IPSS urinary symptom score was 2 (2–5) one year after surgery. In parallel, the median IPSS QoL score and mean PVR reached 1 (0–1) and 23.6 ml (25.5) in the 12th month. At 1- and 3-month follow-up, filling phase symptoms were predominant in almost two-thirds of the study population. Within the patients who reported a prevalence of filling phase symptoms at 3 months, 27 of 38 (71%) reported a de novo onset of these symptoms after surgery.ConclusionAquablation is a safe procedure for treating BPH-related LUTS, and it has been demonstrated to be effective up to 12 months after the procedure. LUTS of the filling phase were more prevalent than voiding phase ones in the first 3 months following surgery, but showed a self-limited fashion.

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Operative profile, safety and functional outcomes after GreenLight laser prostate surgery: results from a 12 months follow-up multicenter Italian cohort analyses

Cited by 13 publications

References 14 publications

Water vapor therapy (Rezūm) for lower urinary tract symptoms related to benign prostatic hyperplasia: early results from the first Italian multicentric study

Water vapor therapy (Rezūm) for lower urinary tract symptoms related to benign prostatic hyperplasia: early results from the first Italian multicentric study

Functional Results after First- and Second-Generation Temporary Implantable Nitinol Device (TIND) for BPH: A Narrative Review of the Literature

Evaluation of LUTS of the filling phase after Aquablation: A prospective single center experience

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