Safety, efficacy and reliability of 180-W GreenLight laser technology for prostate vaporization: review of the literature.

PURPOSE: The aim of this study is to investigate the efficacy and safety of 180-W XPS GreenLight laser technology for photoselective prostate vaporization. PATIENTS AND METHODS: A systematic search of the electronic databases was performed. Inclusion criteria were: full-text peer-reviewed journal article, with original data analysis that evaluates the feasibility and the outcome only of 180-W XPS GL laser system. Data at baseline and during follow-up have been taken into account. Intra-operative and postoperative (functional results and complications) data were collected and analyzed.
RESULTS: We found 165 articles in our research, among which only nine articles were selected (total 991 patients). A certain grade of variability is present in all the studies in terms of scientific design, sample size and methods of reporting functional results and complications. Nevertheless, a homogenous benefit for patients in terms of symptom score improvement, post-void residual volume reduction and urinary max flow rate improvement was shown. According to Clavien-Dindo classification, 292 (83.7%) adverse events were recorded ≤ grade 2. Adverse events ≥ grade 3 were 57 (16.3%), among which bleeding, urinary retention and residual obstructive tissue represented the wide majority. No mortality was reported. Male sexual function was poorly investigated.
CONCLUSIONS: The 180-W XPS GL laser technique is feasible and safe, with a remarkable clinical benefit. Long-term evidence on outcomes and complications are suitable even in the sphere of male sexuality.