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World J Urol. 2017 Dec;35(12):1923-1931. doi: 10.1007/s00345-017-2091-8. Epub 2017 Sep 23.

A novel vaporization-enucleation technique for benign prostate hyperplasia using 120-W HPS GreenLight™ laser: Seoul technique II in comparison with vaporization and previously reported modified vaporization-resection technique.

Author information

1
Department of Urology, Seoul National University College of Medicine, Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Korea.
2
Department of Urology, Seoul National University College of Medicine, Boramae Medical Center, Sindaebang 2(i)-dong, Dongjak-gu, Seoul, 07061, Korea. volley@snu.ac.kr.

Abstract

PURPOSE:

We developed a novel vaporization-enucleation technique (Seoul II), which consists of vaporization-enucleation of the prostate using 120-W HPS GreenLight laser, and enucleated prostate resection using bipolar devices for tissue removal. We compared the outcomes of the Seoul II with vaporization and a previously reported modified vaporization-resection technique (Seoul I).

METHODS:

Among patients with benign prostate hyperplasia who underwent transurethral surgery using GreenLight laser at our institute, 347 patients with prostate volume ≥ 40 ml were included. The impact of surgical techniques on efficacy and postoperative functional outcomes was compared.

RESULTS:

No difference was found in baseline characteristics, although the prostate volume was marginally greater in Seoul II (p = 0.051). Prostate volume reduction per operation time (p < 0.001) and lasing time (p = 0.016) were greater in Seoul II. At postoperative 12 months, the International Prostate Symptom Score (I-PSS) was lower (p = 0.011), and the decrement in I-PSS was greater in Seoul II (p = 0.001) than other techniques. In multivariate analysis, postoperative 12-month I-PSS for Seoul II was significantly superior to vaporization (p < 0.001), although it was similar to Seoul I. The maintenance of immediate postoperative I-PSS decrement, until postoperative 12 months was superior in Seoul II compared with vaporization (p = 0.014) and Seoul I (p = 0.048).

CONCLUSIONS:

Seoul II showed improved efficacy and voiding functional maintenance over postoperative 12 months in patients with prostate volume ≥ 40 ml compared with vaporization and Seoul I. This technique could be easily accepted by clinicians who are familiar with GreenLight lasers and add flexibility to surgery without additional equipment.

KEYWORDS:

Lasers; Prostatic hyperplasia; Transurethral resection of prostate

PMID:
28942591
DOI:
10.1007/s00345-017-2091-8
[Indexed for MEDLINE]

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