Introduction and Objectives
Photoselective vaporization of the prostate (PVP) with Greenlight laser is a promising minimally invasive procedure providing relief of the bladder outlet obstruction due to benign prostatic hyperplasia (BPH) with excellent safety profile. This technique is especially indicated for patients at high cardiac risk or on oral anticoagulation due to haemostatic properties of Greenlight laser. The aim of the study is to evaluate the results of PVP with Greenlight HPS 120W laser in the treatment of first 100 consecutive patients.
Material and Methods
100 consecutive patients underwent PVP with Greenlight HPS 120W laser in years 2006–2008. 65 patients were on anticoagulants due to cardiac diseases. The mean patients’ age was 67.2 years and the mean prostate size was 64.8 ml. We evaluated various objective and subjective parameters before and 1, 6 and 12 months after PVP. Duration of the procedure, time of catheterization and hospitalization as well as morphological and biochemical parameters and intra – and postoperative complications were assessed.
Results
The mean duration of the procedure was 56 minutes. The mean catheterization time after PVP was 18.3 hours. The mean hospitalization time after PVP was 28.1 hours. The mean maximum urinary flow rate (Qmax) improved from 9.7 before to 21.9, 22.5 and 21.8 ml/s at 1, 6 and 12 months, respectively. The mean post-voiding residual volume (PVR) decreased from 116.4 to 33.5, 31.7 and 32.3 ml. IPSS decreased from 24.9 to 11.1, 7.3 and 7.2. QoL score decreased from 4.7 to 2.2, 1.7 and 1.6. There was no major complication during PVP. No significant change in hematocrite and sodium serum level was observed. No blood transfusion was necessary. Most common postoperative complications included transient dysuria and hematuria. 2 patients required recatheterization due to urine retention. 16 out of 42 (38.1%) sexually active patients experienced retrograde ejaculation. 4 patients required second procedure (2 TURP and 2 urethrotomy).
Conclusions
Photoselective vaporization of the prostate with Greenlight HPS 120W laser appears to be effective and safe treatment modality for patients with BPH. Moreover, it can be safely used in patients with cardiac diseases and on oral anticoagulation.
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© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
