TY - JOUR
T1 - Safety, perioperative, and early functional outcomes of vapor incision technique using the GreenLight XPS 180 W system
T2 - Direct comparison with photoselective vaporization of the prostate
AU - Azizi, Mounsif
AU - Tholomier, Côme
AU - Meskawi, Malek
AU - Hueber, Pierre Alain
AU - Valdivieso, Roger F.
AU - Alenizi, Abdullah M.
AU - Rajih, Emad
AU - Zanaty, Marc
AU - Hai, Mahmood A.
AU - Gonzalez, Ricardo R.
AU - Eure, Gregg R.
AU - Kriteman, Lewis S.
AU - Misrai, Vincent
AU - Zorn, Kevin C.
N1 - Publisher Copyright:
© Mary Ann Liebert, Inc. 2017.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017
Y1 - 2017
N2 - Objectives: To compare perioperative parameters, safety, and short-term functional outcomes between GreenLight 180 W-XPS photoselective vaporization of the prostate (PVP) and vapor incision technique (VIT). Materials and Methods: A total of 956 men were treated at five high-volume centers in Canada and the United States between 2000 and 2014 for benign prostatic hyperplasia. Perioperative parameters, complications, and early functional outcomes were retrospectively compared. One-to-one propensity score matching was performed to adjust for baseline differences between treatment groups. Subgroup stratified comparative analysis was performed according to preoperative prostate volume 80 cc or less vs greater than 80 cc on transrectal ultrasound (259 and 185 patients, respectively). Results: VIT allowed greater energy delivery and energy density, but operative time and laser time were longer with greater use of MoXy fibers when compared with PVP (all p < 0.05). Improvements in outcomes at 6 months, including International Prostate Symptom Score, quality of life score, and uroflowmetry parameters, were significantly greater after VIT when compared with baseline. VIT was associated with significantly greater 6-month prostate-specific antigen (PSA) reduction (63% vs 50%, p = 0.01). No differences in intraoperative complications were observed between treatment groups. Conclusion: VIT is safe and efficacious, providing greater improvements in functional outcomes and PSA reduction at 6 months in comparison with PVP. These results reflect the larger amount of adenoma removed. Yet, it is associated with longer operative time and greater use of MoXy fibers. Long-term follow-up is needed to accurately assess functional outcomes and retreatment rates.
AB - Objectives: To compare perioperative parameters, safety, and short-term functional outcomes between GreenLight 180 W-XPS photoselective vaporization of the prostate (PVP) and vapor incision technique (VIT). Materials and Methods: A total of 956 men were treated at five high-volume centers in Canada and the United States between 2000 and 2014 for benign prostatic hyperplasia. Perioperative parameters, complications, and early functional outcomes were retrospectively compared. One-to-one propensity score matching was performed to adjust for baseline differences between treatment groups. Subgroup stratified comparative analysis was performed according to preoperative prostate volume 80 cc or less vs greater than 80 cc on transrectal ultrasound (259 and 185 patients, respectively). Results: VIT allowed greater energy delivery and energy density, but operative time and laser time were longer with greater use of MoXy fibers when compared with PVP (all p < 0.05). Improvements in outcomes at 6 months, including International Prostate Symptom Score, quality of life score, and uroflowmetry parameters, were significantly greater after VIT when compared with baseline. VIT was associated with significantly greater 6-month prostate-specific antigen (PSA) reduction (63% vs 50%, p = 0.01). No differences in intraoperative complications were observed between treatment groups. Conclusion: VIT is safe and efficacious, providing greater improvements in functional outcomes and PSA reduction at 6 months in comparison with PVP. These results reflect the larger amount of adenoma removed. Yet, it is associated with longer operative time and greater use of MoXy fibers. Long-term follow-up is needed to accurately assess functional outcomes and retreatment rates.
KW - benign prostatic hyperplasia
KW - laser
KW - prostate
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U2 - 10.1089/end.2016.0474
DO - 10.1089/end.2016.0474
M3 - Article
C2 - 27841666
AN - SCOPUS:85020680635
SN - 0892-7790
VL - 31
SP - 43
EP - 49
JO - Journal of Endourology
JF - Journal of Endourology
IS - 1
ER -