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Clinical outcomes of secondary or tertiary treatment of benign prostatic hyperplasia (BPH) with GreenLight HPS(tm) laser photoselective vaporization prostatectomy
Vol. 211, No. 3S, September 2010
Does prostate configuration affect the efficacy and safety of GreenLight HPS (tm) Laser photoselective vaporization prostatectomy (PVP)? Xiao Gu MD,PhD, Kurt H Strom MD, Massimiliano Spaliviero MD, Carson Wong MD University of Oklahoma Health Sciences Center, Oklahoma City, OK INTRODUCTION: We evaluate the efficacy and safety of GreenLight HPS (tm) laser PVP for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) with bilobe and trilobe prostates. METHODS: Based on the results of cystoscopy and transrectal ultrasonography, patients were stratified into two groups: bilobe (group I) and trilobe (group II) BPH. American Urological Association Symptom Score (AUASS), Quality of Life (QoL) score, maximum flow rate (Qmax) and post void residual (PVR) were measured preoperatively and at 1 and 4 weeks and 3, 6, 12, 18 and 24 months post-surgery.
Surgical Forum Abstracts
S133
Clinical outcomes of secondary or tertiary treatment of benign prostatic hyperplasia (BPH) with GreenLight HPS(tm) laser photoselective vaporization prostatectomy Kurt H Strom MD, Massimiliano Spaliviero MD, Xiao Gu MD, PhD, Carson Wong MD University of Oklahoma Health Sciences Center, Oklahoma City, OK INTRODUCTION: Secondary procedure rates of surgical therapy for BPH range between 1-14%. We evaluate GreenLight HPS(tm) laser PVP as a treatment for symptomatic BPH previously treated with surgical management. METHODS: Patients who failed prior surgical therapy (transurethral prostate resection (TURP), transurethral microwave therapy (TUMT), holmium laser ablation of prostate (HoLAP) and potassium-titanyl-phosphate (KTP) laser PVP) for symptomatic BPH were included.
RESULTS: 181 consecutive patients were identified (l: 101, ll: 80). Among the preoperative parameters, there were significant differences in prostate volume (I: 46.5 ⫹/- 17.9, II: 97.5 ⫹/- 120.2 mL, p⬍0.001.), Qmax (I: 10.1 ⫹/- 4.2, II: 8.7 ⫹/- 3.5 mL/sec, p⫽0.027) and PVR (I: 60.4 ⫹/- 118.8, II: 97.5 ⫹/- 154.3 mL, p⫽0.074), while AUASS and QoL were similar. Significant differences in laser utilization (I: 8.9 ⫹/- 4.5 II: 19.5 ⫹/- 11.7 minutes, p⬍0.001) and energy usage (I: 59.1 ⫹/- 30.0, II: 131.2 ⫹/- 79.6 kJ, p⬍0.001) were noted. AUASS, QoL and Qmax showed immediate and stable improvement during the follow-up period. There were no significant differences in the postoperative clinical outcome parameters between the two groups (p⬎0.05). The incidence of adverse events were low in both groups.
RESULTS: Prior surgical management included TURP (18), TUMT (9), KTP laser PVP (8), HoLAP (2), TUMT and TURP (1), and TUMT and KTP laser PVP (1) in 39 patients. Mean prostate volume was 80.8 ⫹/- 50.0 mL. Mean laser and operative times and energy usage were 12.5 ⫹/- 10.5 minutes, 30.0 ⫹/- 24.0 minutes and 83.2 ⫹/- 64.4 kJ, respectively. Mean American Urological Symptom Association Score (AUASS) decreased significantly from 22.8 to 8.2, 6.5, 6.5, 5.5, 4.6, 3.6 and 4.6 (p⬍0.05) at 1 and 4 weeks and 3, 6, 12, 18 and 24 months, respectively. Mean maximum flow rate (Qmax) and post void residual (PVR) measurements also showed significant improvement from baseline. The incidence of adverse events were low.
CONCLUSIONS: Our experience suggests that BPH configuration has little effect on the efficacy and safety of GreenLight HPS (tm) laser PVP.
CONCLUSIONS: Our initial results demonstrate that GreenLight HPS(tm) laser PVP is safe and effective for the treatment of symptomatic BPH recurring following prior surgical management.
Does prostate configuration affect the efficacy and safety of GreenLight HPS (tm) Laser photoselective vaporization prostatectomy (PVP)? Xiao Gu MD,PhD, Kurt H Strom MD, Massimiliano Spaliviero MD, Carson Wong MD University of Oklahoma Health Sciences Center, Oklahoma City, OK INTRODUCTION: We evaluate the efficacy and safety of GreenLight HPS (tm) laser PVP for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) with bilobe and trilobe prostates. METHODS: Based on the results of cystoscopy and transrectal ultrasonography, patients were stratified into two groups: bilobe (group I) and trilobe (group II) BPH. American Urological Association Symptom Score (AUASS), Quality of Life (QoL) score, maximum flow rate (Qmax) and post void residual (PVR) were measured preoperatively and at 1 and 4 weeks and 3, 6, 12, 18 and 24 months post-surgery.
Surgical Forum Abstracts
S133
Clinical outcomes of secondary or tertiary treatment of benign prostatic hyperplasia (BPH) with GreenLight HPS(tm) laser photoselective vaporization prostatectomy Kurt H Strom MD, Massimiliano Spaliviero MD, Xiao Gu MD, PhD, Carson Wong MD University of Oklahoma Health Sciences Center, Oklahoma City, OK INTRODUCTION: Secondary procedure rates of surgical therapy for BPH range between 1-14%. We evaluate GreenLight HPS(tm) laser PVP as a treatment for symptomatic BPH previously treated with surgical management. METHODS: Patients who failed prior surgical therapy (transurethral prostate resection (TURP), transurethral microwave therapy (TUMT), holmium laser ablation of prostate (HoLAP) and potassium-titanyl-phosphate (KTP) laser PVP) for symptomatic BPH were included.
RESULTS: 181 consecutive patients were identified (l: 101, ll: 80). Among the preoperative parameters, there were significant differences in prostate volume (I: 46.5 ⫹/- 17.9, II: 97.5 ⫹/- 120.2 mL, p⬍0.001.), Qmax (I: 10.1 ⫹/- 4.2, II: 8.7 ⫹/- 3.5 mL/sec, p⫽0.027) and PVR (I: 60.4 ⫹/- 118.8, II: 97.5 ⫹/- 154.3 mL, p⫽0.074), while AUASS and QoL were similar. Significant differences in laser utilization (I: 8.9 ⫹/- 4.5 II: 19.5 ⫹/- 11.7 minutes, p⬍0.001) and energy usage (I: 59.1 ⫹/- 30.0, II: 131.2 ⫹/- 79.6 kJ, p⬍0.001) were noted. AUASS, QoL and Qmax showed immediate and stable improvement during the follow-up period. There were no significant differences in the postoperative clinical outcome parameters between the two groups (p⬎0.05). The incidence of adverse events were low in both groups.
RESULTS: Prior surgical management included TURP (18), TUMT (9), KTP laser PVP (8), HoLAP (2), TUMT and TURP (1), and TUMT and KTP laser PVP (1) in 39 patients. Mean prostate volume was 80.8 ⫹/- 50.0 mL. Mean laser and operative times and energy usage were 12.5 ⫹/- 10.5 minutes, 30.0 ⫹/- 24.0 minutes and 83.2 ⫹/- 64.4 kJ, respectively. Mean American Urological Symptom Association Score (AUASS) decreased significantly from 22.8 to 8.2, 6.5, 6.5, 5.5, 4.6, 3.6 and 4.6 (p⬍0.05) at 1 and 4 weeks and 3, 6, 12, 18 and 24 months, respectively. Mean maximum flow rate (Qmax) and post void residual (PVR) measurements also showed significant improvement from baseline. The incidence of adverse events were low.
CONCLUSIONS: Our experience suggests that BPH configuration has little effect on the efficacy and safety of GreenLight HPS (tm) laser PVP.
CONCLUSIONS: Our initial results demonstrate that GreenLight HPS(tm) laser PVP is safe and effective for the treatment of symptomatic BPH recurring following prior surgical management.