Open Access

ARTICLE

Short term outcomes of GreenLight vapor incision technique (VIT) of the prostate: comparison of outcomes to standard GreenLight 120W HPS vaporization in prostate volumes greater than 80 cc

Tal Ben-Zvi¹, Pierre-Alain Hueber¹, Firas Abdollah², Daniel Liberman¹, Naeem Bhojani¹, Gagan Gautam³, Kevin C. Zorn^1,3

1 Section of Urology, Department of Surgery, University of Montreal Health Center, Montreal, Quebec, Canada
2 Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
3 Section of Urology, Department of Surgery, University of Chicago, Chicago, Illinois, USA
Address correspondence to Dr. Kevin C. Zorn, University of Montreal Health Center (CHUM), 235, boul. René-Levesque Est, suite 301, Montreal, QC, H2X 1N8 Canada

Canadian Journal of Urology 2013, 20(1), 6633-6639.

Abstract

Introduction: To evaluate a hybrid technique involving GreenLight 120W HPS vapor incision tissue removal in prostate glands > 80 cc.
Materials and methods: Vapor incision technique (VIT) was performed in 25 consecutive men with a prostate > 80 cc by a single surgeon from May 2010 until September 2010. VIT involved adenoma incisions at 5 and 7-o'clock positions followed by 3, 9 and 12 o'clock down to the surgical capsule. Side-fire vaporization along the capsule excised transurethral resection of the prostate (TURP) like tissue strips for later retrieval. Functional evaluations were performed at 1 and 3 months. Outcomes and complications were compared retrospectively to baseline and a size matched- cohort of 25 men who previously underwent standard vaporization-only photoselective vaporization prostatectomy (PVP).
Results: The VIT and control subgroups were comparable. Mean laser time, operative time and energy usage were reduced in the VIT group compared to controls (35 min versus 48 min; 63 min versus 80 min; and 227 k versus 325 kJ respectively; all p < 0.05). At 3 months the VIT subgroup demonstrated improved Qmax and post void residual (PVR) (197% versus 173%, 88% versus 72%; all p < 0.05) compared to control. VIT showed a 68% reduction in mean preoperative PSA at 3 months compared to 50% for the control group (p<0.01). Hospital stay, catheterization time and complication rates were comparable.
Conclusions: Our data demonstrates that VIT provides superior short term outcomes to standard HPS-PVP in men with prostate volumes > 80 cc. VIT appears to be more time-efficient, consumes less energy and obtains tissue for pathological evaluation. Further follow up is required to assess the durability of GreenLight HPS-VIT to PVP vaporization-only for large prostate glands.

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