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Published in: World Journal of Urology 12/2020

01-12-2020 | Benign Prostatic Hypertrophy | Original Article

Operative time comparison of aquablation, greenlight PVP, ThuLEP, GreenLEP, and HoLEP

Authors: David-Dan Nguyen, Vincent Misraï, Thorsten Bach, Naeem Bhojani, James E. Lingeman, Dean S. Elterman, Kevin C. Zorn

Published in: World Journal of Urology | Issue 12/2020

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Abstract

Introduction

The BPH surgical armamentarium is composed of a rapidly expanding number of technologies and techniques. These include greenlight photovaporization of the prostate (PVP), greenlight enucleation of the prostate (GreenLEP), holmium laser enucleation of the prostate (HoLEP), thulium laser enucleation of the prostate (ThuLEP) and, more recently, the aquablation procedure. To the best of our knowledge, no direct comparison in operative time has been performed.

Methods

Data for this study were pooled from five sources. For aquablation, patient-level data from four studies of the aquablation procedure were provided by the device manufacturer as well as from a high-volume commercial user. PVP, GreenLEP, HoLEP, and ThuLEP were performed by high-volume, experienced experts. Endpoints included total operative time, resection time, and proportion of total operative time for resection. General linear models were used to evaluate the relationship between prostate volume (or other continuous predictors) and procedure time.

Results

Total procedure time was related to prostate size. Except for the small prostate size range (size < 40 cc), at any given prostate volume, procedure time was highest for PVP, intermediate for LEPs, and lowest for Aquablation. The relationship between procedure time and prostate size (i.e., slope of the fitted lines) was 0.16 min/g for aquablation, 0.32 min/g, 0.28 min/g and 0.32 min/g for GreenLEP, HoLEP and ThuLEP, respectively, and 0.63 min/g for PVP.

Conclusion

In our analysis of pooled data of multi-surgical techniques and technologies, aquablation provided the lowest operative time across all prostate volumes. PVP had the longest procedure time for prostates > 40 cc.
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Metadata
Title
Operative time comparison of aquablation, greenlight PVP, ThuLEP, GreenLEP, and HoLEP
Authors
David-Dan Nguyen
Vincent Misraï
Thorsten Bach
Naeem Bhojani
James E. Lingeman
Dean S. Elterman
Kevin C. Zorn
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 12/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-020-03137-8

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