TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Laser therapies for benign prostatic hyperplasia are gradually replacing transurethral resection of the prostate. As laser technology has advanced, it has become feasible to treat larger glands with greater efficiency. We report on our experience with varying energy levels on outcomes using the GreenLight XPS system.
Methods: A total of 129 patients that underwent GreenLight laser therapy from 2010–2014 was reviewed. Perioperative variables including IPSS, QoL, Qmax, energy, operative time, EBL and complications were recorded at baseline and postoperatively. The analysis was stratified according to maximum power level ( ≤ 100 W, 120 W, 150 W, and 180 W).
Results: The mean age, prostate volume, energy, operative time, and EBL were: 68.1 yrs/51.1 cc/147750 J/48 min/11mL ( ≤ 100W), 67.5 yrs/80.2 cc/235779 J/67min/13mL (120 W), 70.4 yrs/110.3 cc/318870 J/74min/7mL (150W), and 69.0 yrs/ 111.4 cc/429809 J/88min/53mL (180 W). Statistically significant improvements compared to baseline were noted in IPSS, QoL, and Qmax at 3, 6, 12 and 24 months between the groups (p < 0.05). Higher maximum power levels were associated with statistically higher total energy usage and operative times (p < 0.05). Patients in the 180W vs. 150W group had similar mean prostate volumes, however bleeding complications were significantly higher in the 180W group (33%) as compared to the 150W group (9%).
Conclusions: There is limited literature available regarding the relationship between maximum power level and outcomes of GreenLight laser therapy. Higher power levels are associated with larger prostate volumes. A maximum power level of 180W is associated with increased bleeding and longer operative times compared to a power level of 150W for similar prostate volumes. Prostate volume, surgeon experience, and patient comorbidities should be considered in selecting appropriate power levels.
Source of Funding: None
|Listen to an interview with Leonard Glickman, one of the authors of this study.|
Presented by Preeya Khandge,1, 2 Amanda Cole,1, 2 Juan Javier-DesLoges,1, 2 Mina Fam,1, 2 Christina Carpenter,1, 2 Leonard Glickman,1 Kevin Basralian,1, 2, 3 and Ravi Munver1, 2, 3 at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
1Hackensack University Medical Center, USA
2Rutgers-New Jersey Medical School, USA
3John Theurer Cancer Center, USA