GreenLight HPS laser 120 W vs diode laser 300 W vaporization of the prostate for the treatment of benign prostatic hyperplasia in Japanese patients: A prospective, single‐center, randomized clinical trial

Abstract

Objectives: This study aimed to compare the safety and efficacy of laser vaporization with 532 nm GreenLight High Performance System (HPS) laser 120 W (PVP) and 980 nm diode laser 300 W (CVP) for the treatment of benign prostatic hyperplasia (BPH) in a prospective, single-center, randomized clinical trial. Methods: A total of 153 consecutive patients with symptomatic BPH were included; 79 patients were treated with PVP and 74 with CVP. Patients were assessed preoperatively and at 3, 6, and 12 months postoperatively using the International Prostate Symptom Score, quality of life index, peak urinary flow rate, and postvoid residual urine volume. All perioperative and postoperative complications were noted. Results: There were significant and comparable improvements in each of the outcome variables over a follow-up period of 12 months in both groups. The mean operation/vaporization duration (minutes) was comparable at 74/38 (PVP) and 76/34 (CVP), whereas the mean applied laser energy was significantly higher with CVP than with PVP at 260 vs 195 (kJ), respectively. The mean vaporization rate (mL/min) was not significantly different between the two groups (0.53 PVP vs 0.56 CVP). Immediately after surgery, the rate of recatheterization for urinary retention was significantly higher with CVP than with PVP (17.6% vs 6.8%; P < 0.05). Conclusions: Both laser systems provided comparable improvement in the subjective and objective parameters with excellent hemostatic properties. Although our results suggest that both procedures are useful treatment choices, further follow-up is needed to draw definitive conclusions regarding the most ideal laser for treating patients with symptomatic BPH.

A prospective, single‐center, randomized clinical trial to evaluate the efficacy of three types of laser vaporization surgeries using a 180‐W GreenLight XPS laser, a 300‐W diode laser, and a 200‐W thulium laser for the treatment of benign prostatic hyperplasia

“…The perioperative and postoperative complications observed in this study are in line with previous reports. 1,2,5,6,7,10,17 Our study confirmed the absence release of bladder outlet obstruction. The rate of epididymitis after DVP was reported to be higher than PVP in previous studies 6 ; however, this study found no significant difference between DVP, PVP, and ThuVAP during follow-up.…”

“…The feasibility of laser ablation for BPH on anticoagulants was elucidated by previous studies. 6,15,16 During this trial, PVP, DVP, and ThuVAP were all performed without severe complications in patients on anticoagulants, suggesting a favorable safety profile for all of these techniques even in high-risk patients.…”

“…4 A recent study on diode lasers with an end-firing contact fiber showed a comparable efficacy to conventional TURP 5 or high-performance system (HPS)-PVP using the GreenLight HPS (120 W). 6 In addition, vaporesection/vapoenucleation of the prostate using the Cyber TM, a thulium laser system (wavelength 2010 nm, maximum output 200 W) has also been available since April 2018. This technique also showed a comparable safety and efficacy to HPS-PVP in patients with symptomatic BPH.…”

“…This laser can simultaneously absorb water and hemoglobin and is considered to be an excellent combination of high tissue ablative performance and good hemostatic properties 4 . A recent study on diode lasers with an end‐firing contact fiber showed a comparable efficacy to conventional TURP 5 or high‐performance system (HPS)‐PVP using the GreenLight HPS (120 W) 6 . In addition, vaporesection/vapo‐enucleation of the prostate using the Cyber TM, a thulium laser system (wavelength 2010 nm, maximum output 200 W) has also been available since April 2018.…”

Endoscopic vaporization of benign prostatic hyperplasia using a contact 980 nm diode laser under antithrombotic therapy: A prospective survey

“…12 In addition, unlike in conventional surgery, in CVP, it is not necessary to suspend antithrombotic therapy during the perioperative period, so even if it is difficult to suspend treatment with anticoagulant or antiplatelet drugs due to arrhythmia or cerebrovascular disease, it is possible to perform transurethral surgery in patients under continued antithrombotic therapy. 13 Our prospective survey revealed the following points.…”