Durability and complications of photoselective vaporisation of the prostate with the 120W high performance system GreenLight™ lithium triborate laser

• Published in: Annals of the Royal College of Surgeons of England 2014-07, Vol.96 (5), p.359-363
• Main Authors: Batura, D, Sahibzada, I, Elkabir, J, Feyisetan, O, Izegbu, V, Hellawell, G, Webster, J
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Aged; Antigens; Bladder; Borates; High performance systems; Humans; Laser Therapy - adverse effects; Laser Therapy - methods; Lasers; Length of Stay; Lithium; Lithium Compounds; Male; Middle Aged; Operative Time; Potassium; Prospective Studies; Prostate; Prostatic Hyperplasia - surgery; Retrospective Studies; Sepsis; Surgery; Surgical outcomes; Survival analysis; Transurethral Resection of Prostate - adverse effects; Transurethral Resection of Prostate - methods; Urology; Variables
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588414X13946184901047

The aim of this study was to examine the durability of photoselective vaporisation of the prostate (PVP) with the 120W GreenLight HPS(®) laser (American Medical Systems, Minnetonka, MN, US), and to examine the incidence, nature and factors associated with complications from the procedure. Clinical records of PVP patients were reviewed to compare details between patients who developed complications and those who did not. Kaplan-Meier survival curves were used to assess durability. Cox regression was used to examine associations between complications and perioperative factors. Successful outcomes were maintained in 84% of 117 patients at the 2-year follow-up appointment. Complication rates were low and comparable with transurethral resection of the prostate (TURP). Complications were developed by 18 patients (15.4%) over a mean follow-up duration of 20.8 months. The most common complications were residual prostate requiring another surgery (5/117, 4.3%) and urethral stricture (4/117, 3.4%). Patients with complications had significantly longer catheterisation duration. Length of hospital stay, lasing energy, pre and postoperative levels of prostate specific antigen (PSA), pre and postoperative maximum flow rate (Qmax), and age at surgery were not found to influence development of complications. Results from PVP with an HPS(®) laser are durable. Complications are low and compare favourably with TURP. Lasing energy, PSA, Qmax, patient age and length of stay are not associated with development of complications. However, a longer postoperative catheterisation after PVP is associated with development of complications.