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Standard vs. anatomical 180-W GreenLight laser photoselective vaporization of the prostate: a propensity score analysis.

Abstract：

PURPOSE:To compare the efficacy, safety, Patient Global Impression of Improvement (PGI-I), and complications rates after 180-W GreenLight laser (180-W GL laser) standard and anatomical photoselective vaporization (sPVP and aPVP). METHODS:Within a multi-institutional database, we identified patients who underwent sPVP or aPVP to relief BPH symptoms. IPSS, Q max, and prostate-specific antigen (PSA) were measured at baseline and during the follow-up. PGI-I score as well as early and late complications were recorded at follow-up visits. Log-binomial and multivariable proportional odds regression models were fitted to estimate the effect of aPVP vs. sPVP on PGI-I as well as on early and late complication rates, before and after adjustment for propensity score. RESULTS:813 patients were included. Of those, the 50.4% underwent aPVP. Patients who underwent aPVP had larger prostate (64 vs. 55 mL, p < 0.001) and higher baseline PSA levels (3.1 vs. 2.5 ng/mL, p < 0.001). PGI-I score was signaled as very improved, improved, slightly improved, unchanged, or worsened in 55.5, 32.8, 8.3, 2.3, and 1.2% of the cases, respectively, with no differences according the technique used (p = 0.420). Acute urinary retention occurred in 9.2 vs. 8.9% of patients after aPVP vs. sPVP (p = 0.872). All models failed to find differences in: patients' satisfaction (OR 1.19, p = 0.256), early complications (RR 0.93, p = 0.387), early urge/incontinence symptoms (RR 0.97, p = 0.814), and late complications rates (RR 0.70, p = 0.053), after aPVP vs. sPVP. CONCLUSION:Our results showed similar functional results and complication rates after aPVP and sPVP. However, aPVP was used in larger prostates. Both techniques guarantee high patient's satisfaction.

journal_name

World J Urol

journal_title

World journal of urology

authors

Cindolo L,De Nunzio C,Greco F,Destefanis P,Bergamaschi F,Ferrari G,Fasolis G,Palmieri F,Divan C,Oriti R,Ruggera L,Tubaro A,Dadone C,De Rienzo G,Frattini A,Mirone V,Schips L,Members of Green Laser Italian Group.

doi

10.1007/s00345-017-2106-5

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

91-97

issue

eissn

0724-4983

issn

1433-8726

pii

10.1007/s00345-017-2106-5

journal_volume

pub_type

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Standard vs. anatomical 180-W GreenLight laser photoselective vaporization of the prostate: a propensity score analysis.