Greenlight laser photoselective vaporization in male patients with enlarged prostates

This study compared the long-term outcomes between photoselective vaporization (PSV) and open prostate surgery (OPS) for patients with an enlarged prostate. Researchers suggested that PSV is a good and safe method for the treatment of these patients.

Patients with an enlarged prostate have a condition called benign prostate hyperplasia. It is a common condition in older men and it causes uncomfortable urinary symptoms such as blockage of urine. In men with large prostates (over 80 ccs), OPS is a standard treatment. However, this treatment is associated with blood loss, long hospital stay, and a long time with a catheter (a tube that passes urine out of the bladder).

PSV might be a treatment alternative to OPS. During PSV a laser is inserted into the penis to burn away extra tissue blocking urine flow through the prostate. Prior studies showed PSV effectiveness and low complication risk. However, the long-term effectiveness and safety of PSV compared to OPS in men with prostates over 80 ccs have not been compared.

This study included information about 332 men with an enlarged prostate (80 ccs or more). Of these, 132 received PSV, and 200 received OPS. The average follow-up after PSV was 48 months, while for OPS was 54 months.

Major complications were more common in the surgery group (12.5%) when compared to the PSV group (1.5%). The average length of hospital stay and catheterization were significantly shorter with PSV (1 day) compared to OPS (3-5 days). After 1 month more patients in the PSV group had urinary urgency (13.6%) compared to the OPS group (2.5%). However, after 12 months, this percentage was similar in the PSV group (3.8%) and OPS group (5%).

After 3 months, the urine flow rate was higher and the residual urine volume was lower in the OPS group. However, after 1 year these parameters were similar between groups. Both groups were similar in urinary symptoms but the quality of life was better in the OPS group. The PSV group needed more prostate treatments (15.2%) when compared to the OPS group (0%).

This study concluded that PSV is a good and safe alternative treatment for patients with an enlarged prostate.

This study was based on medical records. Therefore, information might be missing. More studies are necessary.