EAU 2018: Risk Factors of Short-Term Surgical Retreatment After Greenlight Laser Therapy for Benign Prostate Hyperplasia: A Multi-Institutional Analysis

Copenhagen, Denmark (UroToday.com) Dr. I. Ouzaid, a clinical urologist from the Bichat Hospital in Paris, France, presented his center’s findings on the risk factors of short-term surgical reintervention of obstruction after Greenlight™ photoselective vaporization of the prostate (PVP) for the treatment of benign prostatic hyperplasia (BPH). Though the procedure is widely accepted among urologists, Dr. Ouzaid reiterated how it does, at times, produce morbidity which may result in repeat surgery. Within this study, data of patients who were treated with Greenlight PVP at one of  three different institutions were extracted retrospectively and used for analysis. The primary endpoint of this analysis was to study patients who required a secondary surgical procedure for obstruction within the first year after initial PVP for BPH. Possible follow-up procedures included PVP, transurethral resection of the prostate (TURP), endoscopic urethrotomy (EU), or bladder neck resection (BNR). 

After a comprehensive database search, 777 patients met the inclusion criteria, of which 32 patients (4.1%) had a repeat procedure for obstruction within the first year of PVP for BPH. Of these 32 patients, 3 underwent secondary PVP, 8 TURP, 11 EU, and 10 BNR. Data analysis was split into patients with no follow up surgery (n=745) and patients who did have follow up surgery (n=32). Between these two groups, patient demographics, disease characteristics, functional questionnaires (International Prostate Symptom Score (IPSS) and Quality of Life), and operative laser parameters were not significantly different. However, patient age, operative laser features, and IPSS improvement were significantly greater in the secondary procedure cohort. 

In conclusion, the factors associated with reintervention after Greenlight PVP for the treatment of BPH imply that the impact of surgeon-related features, such as operative laser settings, is the most important determination of functional outcomes of these patients. Operative quality indicators while performing PVP should be standardized during the training process. 


Presented by: Dr. I. Ouzaid, Bichat Hospital, Dept. of Urology, Paris, France

Co-Authors: Gerbaud F. 1, Ravery V. 1, Mathieu R. 2 , Lebdai S. 3, Bensalah K. 2, Abdel Rahmene A. 3, Vincendeau S. 2
Author Information:
1. Bichat Hospital, Dept. of Urology, Paris, France
2. CHU Rennes, Dept. of Urology, Rennes, France
3. CHU Angers, Dept. of Urology, Angers, France

Written by: Zachary Valley, Department of Urology, University of California-Irvine at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark