TY  - EJOU
AU  - Hueber, Pierre-Alain 
AU  - Ben-Zvi, Tal 
AU  - Liberman, Daniel 
AU  - Bhojani, Naeem 
AU  - Gautam, Gagan 
AU  - Deklaj, Tom 
AU  - Katz, Mark 
AU  - Zorn, Kevin C. 

TI  - Mid term outcomes of initial 250 case experience with GreenLight 120W-HPS photoselective  vaporization prostatectomy for benign prostatic hyperplasia: comparison of prostate volumes < 60 cc, 60 cc-100 cc and > 100 cc
T2  - Canadian Journal of Urology

PY  - 2012
VL  - 19
IS  - 5
SN  - 1488-5581

AB  - <b>Introduction:</b> The aim of this study was to compare the efficacy of GreenLight 120-HPS (American Medical Systems, Minnetonka, Minnesota, USA) laser vaporization for men with obstructive benign prostatic hyperplasia (BPH) according to prostate volumes: <60 cc, 60–100 cc, and >100 cc.<br/>
<b>Material and methods:</b> The clinical data of 250 men with symptomatic BPH who underwent photoselective vaporization prostatectomy (PVP) by a single surgeon between July 2007 and August 2009 were retrospectively analyzed. Prostate volumes were measured by transrectal ultrasonography (TRUS). Functional evaluations were performed at 3, 6, and 12 months, with prostate-specific antigen (PSA) levels obtained at 6 months. All men were stratified into three groups according to TRUS volume.<br/>
<b>Results:</b> Among the 250 consecutive PVP patients, 134, 76, and 40 men had prostate volumes <60 cc, 60–100 cc, and >100 cc, respectively. Mean laser time and delivered energy were 31, 44, and 59 minutes; and 163, 309, and 473 kJ, respectively (p < 0.01 for all). At one year, mean International Prostate Symptom Score (IPSS) improved by 69%, 63%, and 50%; Qmax increased by 194%, 175%, and 162%; and post-void residual (PVR) decreased by 88%, 81%, and 71%, respectively (p < 0.01 for all). Mean decrease in preoperative PSA at 6 months was 63%, 52%, and 41%, respectively (p < 0.01). Hospital stay, catheterization time, and complication rates were comparable between groups. However, retreatment rates were significantly higher for prostates >100 cc (1.5% vs. 2.6% vs. 9%; p = 0.02).<br/>
<b>Conclusions:</b> Although larger prostates require more time and energy delivery, PVP is safe and efficacious for patients with lower urinary tract symptoms (LUTS) regardless of prostate size. Laser vaporization for glands >100 cc appears to have a reduced reduction in PSA and a higher 9% rate of retreatment, indicating that PVP for larger prostates remains to be optimized.
KW  - laser photoselective vaporization
KW  -  prostatectomy
KW  -  prostate size
KW  -  GreenLight 120W-HPS

DO  -