Re: GreenLight™ Laser (XPS) Photoselective Vapo-enucleation Versus Holmium Laser Enucleation of the Prostate for the Treatment of Symptomatic Benign Prostate Hyperplasia: A Randomized Controlled Study

Bachmann, Alexander; Rieken, Malte

doi:10.1016/j.eururo.2014.12.066

Cited by 4 publications

(1 citation statement)

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“…Open prostatectomy is an effective alternative, but due to its safety profile (blood transfusion rates 7–14%), it is considered an invasive option [ 13 , 14 ]. Holmium laser enucleation is an accepted alternative for treating obstructing glands > 70 to 80 cc, but requires special equipment and a high-power laser [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Low-pressure monopolar electroresection of the prostate for glands sized > 70 vs. < 70 cc performed with continuous irrigation and suprapubic suction: perioperative and long-term outcome

et al. 2018

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PurposeTo evaluate long-term efficacy and safety of low-pressure transurethral resection of the prostate for prostates < 70 cc (group 1) vs. > 70 cc (group 2).Patients and methodsIn this study patients operated with monopolar TURP between 2009 and 2012 were evaluated retrospectively. During surgery a specially designed trocar (18 Fr) was placed suprapubically and connected to a suction pump to maintain stable low-pressure conditions. After sample size calculations, long-term follow-up was completed for 70 invited patients in each group up to 9/2015.ResultsFollow-up period was 57 vs. 56 months for group 1 and 2, respectively (p = 0.56). At baseline there was no significant difference in age, IPSS, peak flow, and post void residual (PVR). Mean prostate volume was 47 cc (15–65) vs. 100 cc (70–163). Mean operating time was 55.4 vs. 82.6 min (p = 0.00). Blood transfusion was necessary in 0.0 vs. 2.9% (p = 0.16), and 0.0 vs. 1.4% developed TUR syndrome (p = 0.32). At follow-up mean relative improvement in IPSS was 63 vs. 57% (p = 0.29), QoL 64 vs. 64% (p = 0.93), peak flow 139 vs. 130% (p = 0.85), and PVR 58 vs. 63% (p = 0.80). Long-term complications included recurring adenoma in 1.4 vs. 4.3% (p = 0.31), and stricture in 7.2 vs. 5.8% (p = 0.73). 1 patient in each group reported worsening incontinence symptoms.ConclusionsIn terms of safety and efficacy, the aforementioned modality of standardized monopolar TURP using suprapubic suction was non-inferior for prostates > 70 cc compared to the same procedure for prostates < 70 cc. This technique is a potential low-cost alternative for clinics that cannot afford modern laser approaches.Study register numberDRKS00006527.

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Section: Discussionmentioning

confidence: 99%