Point-Counterpoint: Greenlight laser enucleation for management of benign prostatic hyperplasia: a review of current literature.

To discuss the benefits of Greenlight laser enucleation (GreenLEP) compared to endosurgical (Holmium Laser Enucleation of the Prostate (HoLEP) and photovaporization (PVP) of the prostate (PVP)) and open simple prostatectomy (OSP) for management of benign prostatic hyperplasia (BPH).

GreenLEP balances optimal tissue removal with associated increase in maximal flow rate (Qmax) while minimizing post-operative side effects and decreasing surgical time when directly compared to both HoLEP and PVP. GreenLEP has a learning curve that is statistically significantly shorter than HoLEP (pentafecta achieved in 18 vs. 40 cases). Compared to OSP, GreenLEP decreased transfusion rate (0.5 vs. 8.3% p=0.0001) and 30-day complications (20.6 vs. 37.2%, p=0.0003) without significantly changing 6-month efficacy or post-operative complication rate.

GreenLEP appears to be an ideal surgical technique to achieve optimized patient satisfaction compared to HoLEP, PVP, and OSP in men with BPH.

Current opinion in urology. 2019 Mar 27 [Epub ahead of print]

Kiersten M Craig, Richard K Lee

New York Presbyterian/Weill Cornell Medicine, New York, USA.