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World J Urol. 2018 Jan;36(1):91-97. doi: 10.1007/s00345-017-2106-5. Epub 2017 Nov 1.

Standard vs. anatomical 180-W GreenLight laser photoselective vaporization of the prostate: a propensity score analysis.

Author information

1
Department of Urology, ASL Abruzzo2, Via S. Camillo de Lellis 1, 66054, Vasto, Chieti, Italy. lucacindolo@virgilio.it.
2
Department of Urology, "Sant'Andrea" Hospital, Sapienza University, Rome, Italy.
3
Department of Urology, "Federico II" University, Naples, Italy.
4
Department of Urology, Azienda Ospedaliera Città della Salute e della Scienza di Torino-Sede Molinette, Turin, Italy.
5
Department of Urology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
6
Department of Urology, "Hesperia" Hospital, Modena, Italy.
7
Department of Urology, "S. Lazzaro" Hospital, Alba, Italy.
8
Department of Urology, Santa Maria delle Croci Hospital, Ravenna, Italy.
9
Department of Urology, Rovereto Hospital, Rovereto, Italy.
10
Department of Urology, Ulivella e Glicini Clinic, Florence, Italy.
11
Department of Urology, Clinica urologica azienda ospedaliera-University of Padova, Padua, Italy.
12
Department of Urology, "Santa Croce e Carle" Hospital, Cuneo, Italy.
13
Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy.
14
Department of Urology, "Ercole Franchini" Hospital, Montecchio Emilia, Italy.
15
Department of Urology, ASL Abruzzo2, Via S. Camillo de Lellis 1, 66054, Vasto, Chieti, Italy.

Abstract

PURPOSE:

To compare the efficacy, safety, Patient Global Impression of Improvement (PGI-I), and complications rates after 180-W GreenLight laser (180-W GL laser) standard and anatomical photoselective vaporization (sPVP and aPVP).

METHODS:

Within a multi-institutional database, we identified patients who underwent sPVP or aPVP to relief BPH symptoms. IPSS, Q max, and prostate-specific antigen (PSA) were measured at baseline and during the follow-up. PGI-I score as well as early and late complications were recorded at follow-up visits. Log-binomial and multivariable proportional odds regression models were fitted to estimate the effect of aPVP vs. sPVP on PGI-I as well as on early and late complication rates, before and after adjustment for propensity score.

RESULTS:

813 patients were included. Of those, the 50.4% underwent aPVP. Patients who underwent aPVP had larger prostate (64 vs. 55 mL, p < 0.001) and higher baseline PSA levels (3.1 vs. 2.5 ng/mL, p < 0.001). PGI-I score was signaled as very improved, improved, slightly improved, unchanged, or worsened in 55.5, 32.8, 8.3, 2.3, and 1.2% of the cases, respectively, with no differences according the technique used (p = 0.420). Acute urinary retention occurred in 9.2 vs. 8.9% of patients after aPVP vs. sPVP (p = 0.872). All models failed to find differences in: patients' satisfaction (OR 1.19, p = 0.256), early complications (RR 0.93, p = 0.387), early urge/incontinence symptoms (RR 0.97, p = 0.814), and late complications rates (RR 0.70, p = 0.053), after aPVP vs. sPVP.

CONCLUSION:

Our results showed similar functional results and complication rates after aPVP and sPVP. However, aPVP was used in larger prostates. Both techniques guarantee high patient's satisfaction.

KEYWORDS:

Anatomical photoselective vaporization; BPH; GreenLight laser; LUTS; Standard photoselective vaporization

PMID:
29090340
DOI:
10.1007/s00345-017-2106-5
[Indexed for MEDLINE]

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