Photoselective vaporization of the prostate using GreenLight 120-W lithium triborate laser to treat symptomatic benign prostatic hyperplasia: A single-centre prospective study

• Published in: Canadian Urological Association journal 2013-04, Vol.7 (3-4), p.E193-6
• Main Authors: Mosli, Hisham A, Abdel-Meguid, Taha A, Abdulwahhab, Mohammad H, Al-Sayyad, Ahmad, Farsi, Hasan M, Tayib, Abdulmalik
• Format: Article
• Language: English
• Subjects: Care and treatment; Health aspects; Hyperplasia; Lasers in medicine; Lithium; Physiological aspects; Prostate
• ISSN: 1911-6470; 1920-1214
• DOI: 10.5489/cuaj.821

We evaluated the safety and efficacy of photoselective vaporization of the prostate (PVP) using GreenLight 120-W lithium triborate (LBO) laser to treat symptomatic small-to-medium sized benign prostatic hyperplasia (BPH). This prospective non-controlled observational study included symptomatic BPH men ≥50 years with international prostate symptom score (IPSS) ≥14, prostate volume (PV) [less than or equal to]80 cc and maximum flow rate (Q-max) [less than or equal to]15 mL/s. PVP was performed using the GreenLight 120-W LBO laser machine. Patients were assessed at baseline and postoperatively at discharge, 2 weeks, and 3, 6 and 12 months. We measured changes in IPSS, PV, PSA, Q-max, post-void residual (PVR), hemoglobin (Hb), serum sodium (Na+) and reported complications. Statistical significance was p < 0.05. The study included 103 men with mean age of 67 (+-standard deviation)+-9.7 years. Thirty patients were on indwelling urethral catheters for refractory urinary retention and 12 on ongoing anticoagulants. The mean baseline IPSS, PV, PSA, Q-max and PVR parameters significantly improved at follow-up (p < 0.001; each). Mean measurements at baseline versus at six months were: IPSS 25.6 +- 4.2 vs. 7.4+-2.3; PV 44.6 +- 9.2 vs. 21.6 +- 6.3 cc (51.6% reduction); Q-max 5.8 +- 3.4 vs. 20.4 +- 4.8 mL/s; PVR 110 +- 40 vs. 35 +- 9 cc. Mean baseline Hb and serum Na+ declined non-significantly (p [greater than] 0.05) at discharge and at 2 weeks. No patient needed a blood transfusion. Secondary procedures were needed in 2 patients for urethral and bladder neck strictures. The re-treatment rate for residual adenoma was 0.97%. PVP using the GreenLight 120-W LBO laser to treat small-to-medium sized symptomatic BPH demonstrated significant improvements in efficacy parameters and high safety profile within 12 months of follow-up. The procedure entails good hemostasis with minimal blood loss even in patients receiving ongoing anticoagulants.