[8] Photo-selective vaporisation of the prostate (PVP) with the 180-W GreenLight XPS laser, single-centre experience in high-risk patients
Objective: To evaluate the safety and efficacy of the 180-W GreenLight XPS laser for treating high-risk patients with benign prostatic hyperplasia (BPH) and to assess patient’s satisfaction with treatment. Methods: We retrospectively reviewed the charts of 44 high-risk patients who underwent PVP wit...
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| Autores principales: | , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Taylor & Francis Group
2018
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/b050f6e811e64b52b8d0687166d87ab6 |
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| Sumario: | Objective: To evaluate the safety and efficacy of the 180-W GreenLight XPS laser for treating high-risk patients with benign prostatic hyperplasia (BPH) and to assess patient’s satisfaction with treatment. Methods: We retrospectively reviewed the charts of 44 high-risk patients who underwent PVP with the 180-W GreenLight XPS laser performed by a single surgeon between November 2013 and December 2016, with a follow-up of ⩾1 year. High-risk patients were classified as those who had at least one of the following: on anticoagulant therapy, urinary retention, or prostate size of >100 mL. Preoperative, intraoperative, postoperative, and long-term satisfaction were recorded. Results: In all, 44 patients were included in the study. The mean (range) age was 69.9 (55–88) years. All patients had at least one high-risk factor. In all, 30 patients had urinary retention, 12 had ischaemic heart disease on anticoagulant therapy, the mean (range) prostate size was 111.5 (40–250) mL, 20 patients had a prostate size of <100 mL, and the remaining 24 ⩾ 100 mL. There was renal impairment in six patients, bladder stones in two, previous transurethral resection of the prostate in four, haematuria in six, recurrent urinary tract infections (UTIs) in 11, urinary incontinence in six, and 29 patients had other lower urinary tract symptoms. The mean surgery time was 72.9 min, the mean energy used was 230705 W, the mean laser time was 32 min. One patient required postoperative intensive care unit admission due to a chest infection, one required blood transfusions, three developed UTIs, and one developed urethral stricture. The mean maximum urinary flow rate pre- and postoperatively was 9.7 mL/s and 13.1 mL/s, respectively (statistically significant by repeated measure ANOVA; P < 0.05). In patients with a prostate size of <100 mL, 90% were fully satisfied. All patients would recommend this procedure to others. In patients with a prostate size of ⩾100 mL, 19 were fully satisfied, two were not satisfied, and three did not complete the questionnaire. Conclusion: PVP with 180-W GreenLight XPS laser is an effective and safe modality of treatment in high-risk patients with BPH whatever the size of the prostate. Prospective randomised controlled studies with more patients are needed to further confirm these results. |
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