No abstract

treatment of benign prostatic obstruction (BPO). The need for medical and or surgical retreatment for recurring or residual BPO as well as their predictors will be assessed.METHODS: After IRB approval, a prospectively maintained database was established for patients with BPO for whom greenlight laser photoselective vaporization (PVP) and vapoenucleation (PVEP) of the prostate were carried out between August 2014 to March 2018. Patients' perioperative data and urinary functional outcome parameters and postoperative complications were depicted. The need for retreatment was assessed and its predictors retreatment were evaluated.RESULTS: This study included 248 patients, 157 (63.3%) and 91(36.7%) patients underwent PVP and PVEP with mean prostate volume (60AE18 and 100AE22 ml) respectively. Mean AESD follow up duration was 62AE9 months. At last point follow up, mean AESD percentage of improvement in IPSS was 61AE28 and 78AE20 p[0.03, median (range) percentage of improvement in Q max was 119(-13-549) and 123(-13-649) % p[0.2 and median (range) percentage of PSA reduction was 63(-172-99) and 65(-75-97) % p[0.7 for PVP and PVEP groups respectively. Overall retreatment rate (medical and surgical) was 23% (57 patients), 38 (24.2%) after PVP and 19 (20.9%) after PVEP, p[0.5. The need surgical retreatment was statistically significant more after PVP (table 1). Median (range) time to event (defined as medical or surgical re-intervention) was 20 (1-60) for all cases, 3.5 (0-42) and 30 (18-60) months p[ 0.7 for PVP and PVEP groups respectively. On multivariate analysis, only percent reduction of one-year postoperative PSA was a significant predictor of need for retreatment (surgical/ medical) of recurring or residual BPO (P 0.021, 95% CI 0.018-0.024). The cutoff point was 64.2% (58.2% sensitivity, 73.4% specificity, AUC 0.647, 95% CI 0.52-0.76) above it there is less probability for having BPO retreatment.CONCLUSIONS: Greenlight laser prostatectomy using XPS-180Watt is an effective and versatile tool in treating BPO. Durability of the outcome is predictable with more postoperative PSA reduction.