Kyle W Law1, Côme Tholomier2, David-Dan Nguyen1, Iman Sadri1, Félix Couture3, Ahmed S Zakaria4, David Bouhadana1, Franck Bruyère5, Hannes Cash6,7,8, Maximilian Reimann6, Luca Cindolo9, Giovanni Ferrari9, Carlos Vasquez-Lastra10, Tiago J Borelli-Bovo11, Edgardo F Becher12, Vincent Misrai13, Dean Elterman14, Naeem Bhojani4, Kevin C Zorn15. 1. Faculty of Medicine, McGill University, Montreal, QC, Canada. 2. Department of Surgery, Division of Urology, McGill University, Montreal, QC, Canada. 3. Department of Surgery, Division of Urology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada. 4. Department of Urology, University of Montreal Hospital Center CHUM, Montreal, QC, Canada. 5. Department of Oncology and Urology, Centre Hospitalier Universitaire de Tours, Centre-Val de Loire, France. 6. Department of Urology, Charité-Universitaetsmedizin Berlin, Berlin, Germany. 7. PROURO, Berlin, Germany. 8. Department of Urology, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany. 9. Department of Urology, Hesperia Hospital, Cure Group, Modena, Italy. 10. Department of Urology, ABC Medical Center, Mexico City, Mexico. 11. Borelli Urologia, Ribeirão Presto, Brazil. 12. Centro de Urologia, CDU, Buenos Aires, Argentina. 13. Department of Urology, Clinique Pasteur, Toulouse, Midi-Pyrenees, France. 14. Division of Urology, Department of Surgery, University. Health Network, University of Toronto, Toronto, ON, Canada. 15. Department of Urology, University of Montreal Hospital Center CHUM, Montreal, QC, Canada. zorn.chumurology@gmail.com.
Abstract
INTRODUCTION: Greenlight photo-selective vaporization of the prostate (GL-PVP) has gained international acceptance as a safe and effective alternative procedure for the treatment of benign prostatic hyperplasia (BPH), especially in anticoagulated men. This descriptive analysis aims to characterize the current state of GL-PVP, pooling data from international centers. METHODS: Data from 3627 patients who underwent GL-PVP with the XPS-180 W system in seven international centers performed by eight expert surgeons between 2011 and 2019 were retrospectively analyzed. Demographic, perioperative, and postoperative data were collected, including IPSS, QoL, Qmax, PVR, and PSA, and complications. RESULTS: At baseline, median age, prostate volume, PSA, and IPSS were 70 years (interquartile range 64-77), 64 (47-90), 3.1 ng/mL (1.8-6), and 22 (19-27), respectively. Median lasing and operative time were 34 (23-48) and 62 min (46-85), respectively. Median energy use was 250.0 kJ (168.4-367.9), with 92.6% of procedures being completed with one laser fiber. In 60.1% of cases, catheter was removed on postoperative day 1 with median length of 2 days. All-cause mortality within 30 days was 0.3%. Median PSA reduction at 3 months and 60 months compared to baseline was 43.9 and 46.4%, respectively (p < 0.001). All functional outcomes (IPSS, QoL, Qmax, and PVR) were significantly improved across study period when compared to baseline (p < 0.001). For those men with longer follow-up available, the observed surgical BPH retreatment rate was 1.5% CONCLUSION: Using the largest multi-user, international database of GL-PVP, Greenlight XPS laser treatment in experienced hands is a safe, effective, and durable BPH treatment option.
INTRODUCTION: Greenlight photo-selective vaporization of the prostate (GL-PVP) has gained international acceptance as a safe and effective alternative procedure for the treatment of benign prostatic hyperplasia (BPH), especially in anticoagulated men. This descriptive analysis aims to characterize the current state of GL-PVP, pooling data from international centers. METHODS: Data from 3627 patients who underwent GL-PVP with the XPS-180 W system in seven international centers performed by eight expert surgeons between 2011 and 2019 were retrospectively analyzed. Demographic, perioperative, and postoperative data were collected, including IPSS, QoL, Qmax, PVR, and PSA, and complications. RESULTS: At baseline, median age, prostate volume, PSA, and IPSS were 70 years (interquartile range 64-77), 64 (47-90), 3.1 ng/mL (1.8-6), and 22 (19-27), respectively. Median lasing and operative time were 34 (23-48) and 62 min (46-85), respectively. Median energy use was 250.0 kJ (168.4-367.9), with 92.6% of procedures being completed with one laser fiber. In 60.1% of cases, catheter was removed on postoperative day 1 with median length of 2 days. All-cause mortality within 30 days was 0.3%. Median PSA reduction at 3 months and 60 months compared to baseline was 43.9 and 46.4%, respectively (p < 0.001). All functional outcomes (IPSS, QoL, Qmax, and PVR) were significantly improved across study period when compared to baseline (p < 0.001). For those men with longer follow-up available, the observed surgical BPH retreatment rate was 1.5% CONCLUSION: Using the largest multi-user, international database of GL-PVP, Greenlight XPS laser treatment in experienced hands is a safe, effective, and durable BPH treatment option.
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