Top

Published in:

01-05-2017 | Original Article

GreenLight laser photoselective vaporization of the prostate for treatment of benign prostate hyperplasia/lower urinary tract symptoms in patients with different post-void residual urine

Authors: Fei Luo, Hong-Hong Sun, Yan-Hui Su, Zhi-Hua Zhang, Ya-Shen Wang, Zhen Zhao, Jian Li

Published in: Lasers in Medical Science | Issue 4/2017

Abstract

The purpose of this study is to assess the safety and efficacy of GreenLight laser photoselective vaporization of the prostate (PVP) for the treatment of benign prostate hyperplasia/lower urinary tract symptoms (BPH/LUTS) in patients with different post-void residual urine (PVR). BPH/LUTS patients treated with PVP from January 2014 to January 2016 were enrolled in the present study. All patients were divided into PVR > 50, 50 ≤ PVR < 400, and PVR ≥ 400 ml groups, and standard general and urological methods for BPH/LUTS were carried out. PVP surgery was performed, and the follow-up outcome was investigated 6 months after surgery. A total of 429 patients were included, and there were no significant differences in comorbid diseases or habits among the three groups. The maximum urinary flow rate (Qmax) differed significantly among the groups (P < 0.001), while patients in the PVR < 50 ml group had higher maximum detrusor pressure (Pdet.max) level than the other two groups (P < 0.001). Patients in 50 ≤ PVR < 400 (P < 0.001) and PVR ≥ 400 (P < 0.001) ml groups were more likely to develop detrusor underactivity than those in the PVR < 50 ml group. All patients were treated with PVP, and there were no severe complications requiring rehospitalization or reoperation except nine designed re-treatments. Follow-up data of 387 patients were available. Significant improvement in outcome parameters (International Prostate Symptom Score [IPSS], Qmax, and PVR) was observed in comparison with baseline measurements for the three groups. PVP significantly improved the IPSS, Qmax, and PVR in patients with different PVR; PVP is a safe and effective procedure for BPH/LUTS patients.

Gacci M, Eardley I, Giuliano F, Hatzichristou D, Kaplan SA, Maggi M, McVary KT, Mirone V, Porst H, Roehrborn CG (2011) Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol 60(4):809–825. doi:10.1016/j.eururo.2011.06.037 CrossRefPubMed

McVary KT (2006) BPH: epidemiology and comorbidities. Am J Manag Care 12(5 Suppl):S122–S128PubMed

Gacci M, Corona G, Salvi M, Vignozzi L, McVary KT, Kaplan SA, Roehrborn CG, Serni S, Mirone V, Carini M, Maggi M (2012) A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol 61(5):994–1003. doi:10.1016/j.eururo.2012.02.033 CrossRefPubMed

Cornu JN, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, McVary K, Novara G, Woo H, Madersbacher S (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67(6):1066–1096. doi:10.1016/j.eururo.2014.06.017 CrossRefPubMed

Bachmann A, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, Grimm MO, Benejam J, Stolzenburg JU, Riddick A, Pahernik S, Roelink H, Ameye F, Saussine C, Bruyere F, Loidl W, Larner T, Gogoi NK, Hindley R, Muschter R, Thorpe A, Shrotri N, Graham S, Hamann M, Miller K, Schostak M, Capitan C, Knispel H, Thomas JA (2014) 180-W XPS GreenLight laser vaporisation versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: 6-month safety and efficacy results of a European Multicentre Randomised Trial—the GOLIATH study. Eur Urol 65(5):931–942. doi:10.1016/j.eururo.2013.10.040 CrossRefPubMed

Ruszat R, Wyler S, Forster T, Reich O, Stief CG, Gasser TC, Sulser T, Bachmann A (2007) Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol 51(4):1031–1038. doi:10.1016/j.eururo.2006.08.006, discussion 1038–1041CrossRefPubMed

Bachmann A, Schurch L, Ruszat R, Wyler SF, Seifert HH, Muller A, Lehmann K, Sulser T (2005) Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 48(6):965–971. doi:10.1016/j.eururo.2005.07.001, discussion 972CrossRefPubMed

Spaliviero M, Araki M, Wong C (2008) Short-term outcomes of Greenlight HPS laser photoselective vaporization prostatectomy (PVP) for benign prostatic hyperplasia (BPH). J Endourol 22(10):2341–2347. doi:10.1089/end.2008.9708 CrossRefPubMed

Cho SY, Park S, Jeong MY, Ro YK, Son H (2012) 120W GreenLight high performance system laser for benign prostate hyperplasia: 68 patients with 3-year follow-up and analysis of predictors of response. Urology 80(2):396–401. doi:10.1016/j.urology.2012.01.063 CrossRefPubMed

10.

Rule AD, Jacobson DJ, McGree ME, Girman CJ, Lieber MM, Jacobsen SJ (2005) Longitudinal changes in post-void residual and voided volume among community dwelling men. J Urol 174(4 Pt 1):1317–1321, discussion 1321–1312; author reply 1322CrossRefPubMed

11.

Sullivan MP, Yalla SV (1996) Detrusor contractility and compliance characteristics in adult male patients with obstructive and nonobstructive voiding dysfunction. J Urol 155(6):1995–2000CrossRefPubMed

12.

McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, Lepor H, McVary KT, Nyberg LM Jr, Clarke HS, Crawford ED, Diokno A, Foley JP, Foster HE, Jacobs SC, Kaplan SA, Kreder KJ, Lieber MM, Lucia MS, Miller GJ, Menon M, Milam DF, Ramsdell JW, Schenkman NS, Slawin KM, Smith JA (2003) The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med 349(25):2387–2398. doi:10.1056/NEJMoa030656 CrossRefPubMed

13.

Roehrborn CG (2006) Alfuzosin 10 mg once daily prevents overall clinical progression of benign prostatic hyperplasia but not acute urinary retention: results of a 2-year placebo-controlled study. BJU Int 97(4):734–741. doi:10.1111/j.1464-410X.2006.06110.x CrossRefPubMed

14.

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):167–178CrossRefPubMed

15.

Li X, Liao L (2016) Updates of underactive bladder: a review of the recent literature. Int Urol Nephrol 48(6):919–930. doi:10.1007/s11255-016-1251-x CrossRefPubMed

16.

Yu Z, Li J, Li Z, Hou R (2015) Photoselective vaporization of the prostate and simultaneous suprapubic cystostomy for the treatment of benign prostatic hyperplasia in patients with mild to severe detrusor underactivity. Urol Int 95(3):269–275. doi:10.1159/000434688 CrossRefPubMed

17.

Guo S, Muller G, Lehmann K, Talimi S, Bonkat G, Puschel H, Gasser T, Bachmann A, Rieken M (2015) The 80-W KTP GreenLight laser vaporization of the prostate versus transurethral resection of the prostate (TURP): adjusted analysis of 5-year results of a prospective non-randomized bi-center study. Lasers Med Sci 30(3):1147–1151. doi:10.1007/s10103-015-1721-x CrossRefPubMed

18.

Al-Ansari A, Younes N, Sampige VP, Al-Rumaihi K, Ghafouri A, Gul T, Shokeir AA (2010) GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia: a randomized clinical trial with midterm follow-up. Eur Urol 58(3):349–355. doi:10.1016/j.eururo.2010.05.026 CrossRefPubMed

19.

Stone BV, Chughtai B, Kaplan SA, Te AE, Lee RK (2016) GreenLight laser for prostates over 100 ml: what is the evidence? Curr Opin Urol 26(1):28–34. doi:10.1097/mou.0000000000000237 CrossRefPubMed

20.

Simforoosh N, Dadkhah F, Hosseini SY, Asgari MA, Nasseri A, Safarinejad MR (1997) Accuracy of residual urine measurement in men: comparison between real-time ultrasonography and catheterization. J Urol 158(1):59–61. doi:10.1097/00005392-199707000-00016 CrossRefPubMed

21.

Memon A, Ather MH (2000) Use of residual fraction instead of residual volume in the evaluation of lower urinary tract symptoms. Tech Urol 6(1):26–28PubMed

22.

Amole AO, Kuranga SA, Oyejola BA (2004) Sonographic assessment of postvoid residual urine volumes in patients with benign prostatic hyperplasia. J Natl Med Assoc 96(2):234–239PubMedPubMedCentral

23.

Hwang EC, Kim SO, Nam DH, Yu HS, Hwang I, Jung SI, Kang TW, Kwon DD, Kim GS (2015) Men with hypertension are more likely to have severe lower urinary tract symptoms and large prostate volume. Lower Urinary Tract Symptoms 7(1):32–36. doi:10.1111/luts.12046 CrossRefPubMed

24.

Wang CC, Chancellor MB, Lin JM, Hsieh JH, Yu HJ (2010) Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years. BJU Int 105(8):1136–1140. doi:10.1111/j.1464-410X.2009.08913.x CrossRefPubMed

25.

Ahmed A, Farhan B, Vernez S, Ghoniem GM (2016) The challenges in the diagnosis of detrusor underactivity in clinical practice: a mini-review. Arab J Urol 14(3):223–227. doi:10.1016/j.aju.2016.06.005 CrossRefPubMedPubMedCentral

26.

Lee KS, Song PH, Ko YH (2016) Does uroflowmetry parameter facilitate discrimination between detrusor underactivity and bladder outlet obstruction? Invest Clin Urol 57(6):437–441. doi:10.4111/icu.2016.57.6.437 CrossRef

27.

Smith PP, DeAngelis A, Kuchel GA (2012) Detrusor expulsive strength is preserved, but responsiveness to bladder filling and urinary sensitivity is diminished in the aging mouse. Am J Physiol Regul Integr Comp Physiol 302(5):R577–R586. doi:10.1152/ajpregu.00508.2011 CrossRefPubMed

28.

Dorsher PT, McIntosh PM (2012) Neurogenic bladder. Adv Urol 2012:816274. doi:10.1155/2012/816274 CrossRefPubMedPubMedCentral

29.

Altay B, Erkurt B, Kiremit MC, Guzelburc V, Boz MY, Albayrak S (2015) 180-W XPS GreenLight laser vaporization for benign prostate hyperplasia: 12-month safety and efficacy results for glands larger than 80 mL. Lasers Med Sci 30(1):317–323. doi:10.1007/s10103-014-1667-4 CrossRefPubMed

30.

Broggi E, May A, Giretti G, Tabchouri N, Lorphelin H, Brichart N, Bruyere F (2014) Long-term outcomes of 80-watt KTP and 120-watt HPS GreenLight photoselective vaporization of the prostate. Urol Int 93(2):229–236. doi:10.1159/000356991 CrossRefPubMed

31.

Yamada Y, Furusawa J, Sugimura Y, Kuromatsu I (2016) Photoselective vaporization of the prostate: long-term outcomes and safety during 10 years of follow-up. J Endourol 30(12):1306–1311. doi:10.1089/end.2016.0522 CrossRefPubMed

32.

Choi SW, Choi YS, Bae WJ, Kim SJ, Cho HJ, Hong SH, Lee JY, Hwang TK, Kim SW (2011) 120 W Greenlight HPS laser photoselective vaporization of the prostate for treatment of benign prostatic hyperplasia in men with detrusor underactivity. Korean J Urol 52(12):824–828. doi:10.4111/kju.2011.52.12.824 CrossRefPubMedPubMedCentral

Title: GreenLight laser photoselective vaporization of the prostate for treatment of benign prostate hyperplasia/lower urinary tract symptoms in patients with different post-void residual urine
Authors: Fei Luo
Hong-Hong Sun
Yan-Hui Su
Zhi-Hua Zhang
Ya-Shen Wang
Zhen Zhao
Jian Li
Publication date: 01-05-2017
Publisher: Springer London
Published in: Lasers in Medical Science / Issue 4/2017
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-017-2190-1

At a glance: The STEP trials

Springer Medicine

GreenLight laser photoselective vaporization of the prostate for treatment of benign prostate hyperplasia/lower urinary tract symptoms in patients with different post-void residual urine

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2017

Histomorphologic and ultrastructural recovery of myopathy in rats treated with low-level laser therapy

Letter regarding “Same strategy for pitfalls of radiotherapy in different anatomical districts”

LLLT actives MMP-2 and increases muscle mechanical resistance after nerve sciatic rat regeneration

Quantifying glucose and lipid components in human serum by Raman spectroscopy and multivariate statistics

The association between Nd:YAG laser and desensitizing dentifrices for the treatment of dentin hypersensitivity

Photobiomodulation of wound healing via visible and infrared laser irradiation