Safety, efficacy and reliability of 180-W GreenLight laser technology for prostate vaporization: review of the literature

Castellan, Pietro; Castellucci, Roberto; Schips, Luigi; Cindolo, Luca

doi:10.1007/s00345-015-1490-y

Cited by 23 publications

(14 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7,16 Since its introduction to the urological armamentarium, several studies reported its superiority to monopolar TURP with shorter hospitalization, shorter catheterization time and faster time to clinical stability. 16,17 More recent studies have demonstrated excellent outcome of 180W XPS GL PVP over a period of 2 years. 6 The current study is unique as it is the first study to the best of our knowledge to report 5-year durability outcomes.…”

Section: Cuaj -Original Research Ajib Et Al Long-term Outcomes With 1mentioning

confidence: 99%

See 1 more Smart Citation

Photoselective vaporization of the prostate with the 180-W XPSGreenlight laser: Five-year experience of safety, efficiency, and functional outcomes

Ajib

Mansour

Zanaty

et al. 2018

CUAJ

View full text Add to dashboard Cite

Introduction: Transurethral resection of the prostate (TURP) is still considered the gold standard surgical treatment for symptomatic benign prostatic hyperplasia (BPH). However, photoselective vaporization of the prostate (PVP) has gained widespread global acceptance in national guidelines as a safe and effective alternative option. Nevertheless, further evidence is required to assess the durability of Greenlight PVP. Herein, we reported our five years PVP experience with the Greenlight 180W XPS laser system. Methods: A retrospective analysis was conducted on a prospectively gathered database of 370 consecutive included patients who underwent PVP using Greenlight XPS-180 W laser system (Boston Scientific, Boston, MA, U.S.) performed by a single experienced laser surgeon between 2011 and 2016. Preoperative characteristics, intervention parameters, postoperative functional, uroflowmetry outcomes, and complications were collected. Outcomes are reported over a period of five years. Results: Mean age was 68 years with a mean prostate volume of 78.8 cc (95% confidence interval [CI] 70.9-78.7]). The mean followup was 59.4 months (55.4-63.5). Mean energy, operative time and energy/cc were 270.2 kJ (255.2-285.2), 62.7 minutes (59.6-65.7), and 3.7 kJ/cc (3.6-3.9), respectively. Compared to preoperative values, International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), and post-void residual (PVR) parameters were significantly improved and sustained over the five postoperative years. To note, only 66 patients (out of 370) had a complete five-year

show abstract

Section: Cuaj -Original Research Ajib Et Al Long-term Outcomes With 1mentioning

confidence: 99%

“…The review of the literature made by Castellan et al revealed that after a 3 and 6 month follow up the PVR decreased significantly. 17 Tasci and al showed that the PVR, after TURP, improved by 116.6 mL after 5 years. The mean PVR was 142 at baseline and 25.4 mL at 5 years.…”

Section: Cuaj -Original Researchmentioning

confidence: 99%

Photoselective vaporization of the prostate with the 180-W XPSGreenlight laser: Five-year experience of safety, efficiency, and functional outcomes

Ajib

Mansour

Zanaty

et al. 2018

CUAJ

View full text Add to dashboard Cite

show abstract

“…However, the mean operative time of PVP can be substantially reduced by improving the surgeon's overall faculties, technical skills, and confidence. Furthermore, recent studies on PVP using lasers with more than 120 W of power (160 W and 180 W) [343536] have been conducted with the goal of reducing the operative time of PVP. In contrast, the catheterization and hospitalization times were significantly shorter in the PVP group.…”

Section: Discussionmentioning

confidence: 99%

“…These discrepancies may theoretically be a source of bias, but do not think that it was significant because this meta-analysis was focused on PVP overall, rather than on laser type or power. As stated above, studies are now evaluating PVP performed with lasers with more than 120 W of power (160 W and 180 W) [343536], but it is too early to present an informed discussion of the efficacy and safety of high-energy PVP. These issues must be addressed in future comparative studies.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Functional Outcomes and Complications Following the Photoselective Vaporization of the Prostate and Monopolar Transurethral Resection of the Prostate

Kang

Ham

Choi

et al. 2016

World J Mens Health

View full text Add to dashboard Cite

PurposeTo perform a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing monopolar transurethral resection of the prostate (MTURP) and photoselective vaporization of the prostate (PVP) in order to provide the most up-to-date and reliable recommendations possible.Materials and MethodsRelevant RCTs were identified from electronic databases for meta-analysis of the surgical outcomes and complications of MTURP and PVP. Meta-analytical comparisons were made using qualitative and quantitative syntheses. The outcome variables are presented as odds ratios with 95% confidence intervals (CIs).ResultsIn total, 11 articles were included in this comparative analysis of PVP versus MTURP. Most of the recently published studies exhibited low risk in terms of quality assessment. MTURP was superior to PVP regarding operative time; however, with regard to catheterization and hospitalization time, the mean differences were -1.39 (95% CI=-1.83~-0.95, p<0.001) and -2.21 (95% CI=-2.73~-1.69, p<0.001), respectively, in favor of PVP. PVP was superior to MTURP with regard to transfusion rate and clot retention, but no statistically significant differences were found with regard to acute urinary retention and urinary tract infection. The long-term complications of bladder neck contracture and urethral stricture showed no statistically significant differences between PVP and MTURP. Long-term functional outcomes, including the International Prostate Symptom Score and maximum flow rate, likewise did not display statistically significant differences between PVP and MTURP.ConclusionsBased on our findings, we believe that PVP should be considered as an alternative surgical procedure for treating male lower urinary tract symptoms secondary to benign prostatic hyperplasia.

show abstract

“…GreenLight TM LV is generally considered a minimally invasive and low-morbidity procedure and excellent short to mid-term functional results have been reported [2]. The coagulation properties of the laser allow for a safe operation even in patients with significant cardiovascular co-morbidities or in patients taking anticoagulants [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Absorption of irrigation fluid during XPS™ GreenLight laser vaporization of the prostate: results from a prospective breath ethanol monitoring study

et al. 2016

View full text Add to dashboard Cite

PURPOSE: To assess whether and to what extent irrigation fluid absorption occurs during laser vaporization (LV) of the prostate using the 180 W XPS™ GreenLight laser. METHODS: This prospective investigation was performed in a tertiary care center with a consecutive series of patients undergoing 180 W LV of the prostate. Intraoperative irrigation was performed with isotonic saline containing 1 % ethanol. The volume of irrigation fluid absorption was calculated from periodically performed breath ethanol measurements during LV. Additionally, intraoperative changes in biochemical and hematological blood parameters were assessed. RESULTS: Positive breath ethanol tests were detectable in 22 of 54 patients. The median absorption volume in these patients was 950 ml (range 208-4579 ml). Ten patients absorbed more than 2000 ml. Absorbers had smaller prostates, more capsular perforations and injuries to venous sinuses, and more total energy was applied with higher output power. Five patients had transient symptoms potentially related to fluid absorption. A significant drop in hemoglobin, hematocrit, venous pH and bicarbonate and an increase in chloride were detectable in the absorber group. These changes were significantly different in the non-absorber group. CONCLUSIONS: Absorption of irrigation fluid did occur in a relevant proportion of patients undergoing XPS™ GreenLight LV. High-volume absorption (2000 ml), which might be clinically relevant, was detectable in almost 20 % of all procedures. Absorption of saline irrigation fluid does not result in a classical TUR syndrome, but fluid and chloride overload can lead to serious complications, particularly in cardiovascular high-risk patients. Thus, patients with symptoms potentially related to fluid absorption should be monitored carefully.

show abstract

Safety, efficacy and reliability of 180-W GreenLight laser technology for prostate vaporization: review of the literature

Abstract: The 180-W XPS GL laser technique is feasible and safe, with a remarkable clinical benefit. Long-term evidence on outcomes and complications are suitable even in the sphere of male sexuality.

Cited by 23 publications

References 23 publications

Photoselective vaporization of the prostate with the 180-W XPSGreenlight laser: Five-year experience of safety, efficiency, and functional outcomes

Photoselective vaporization of the prostate with the 180-W XPSGreenlight laser: Five-year experience of safety, efficiency, and functional outcomes

A Systematic Review and Meta-Analysis of Functional Outcomes and Complications Following the Photoselective Vaporization of the Prostate and Monopolar Transurethral Resection of the Prostate

Absorption of irrigation fluid during XPS™ GreenLight laser vaporization of the prostate: results from a prospective breath ethanol monitoring study

Contact Info

Product

Resources

About