Alternatives to the standard transurethral resection of the prostate (TURP) in the management of bladder outflow obstruction due to prostatic hypertrophy are becoming more common. In this retrospective case series, the outcomes of 117 patients undergoing GreenLightTM lithium triborate photoselective vaporisation of the prostate were evaluated to examine the incidence and types of complications experienced, and procedure success over the mean follow-up period of 20.8 months. Various factors were compared between those who developed complications and those who did not, including duration of catheterisation, length of stay and laser energy used, with univariate and multivariate statistical analysis performed. Overall during the follow-up period, 15.4% of patients developed a complication; 4.3% of patients had residual prostatic tissue requiring reoperation, and 3.4% of patients developed a urethral stricture. Eighty-four percent of patients were free from complications at 24 months. Analysis of the factors influencing complication rates suggested an association between prolonged duration of catheterisation (> five days) and overall higher complication rates, although the reason for this was unclear. The authors report that their complication rates were comparable with those reported in the literature following standard TURP, and that in their institution median length of stay was lower following photoselective vaporisation than in those who had undergone TURP. A randomised control study to further evaluate the two procedures and confirm these findings remains necessary. Initial prostate volume and volume of resected tissue, operative blood loss and operative time were not included in the published study, all of which may influence outcomes and warrant further assessment.
Durability and complications of photoselective vaporisation of the prostate with GreenLightTM
Reviewed by Sophia Cashman
Durability and complications of photoselective vaporisation of the prostate with the 120W high performance system GreenLightTM lithium triborate laser.
