Evaluating the outcomes of GreenLight laser photoselective vaporization in patients with large prostates for the treatment of benign prostatic hyperplasia.

This study evaluated the outcomes of GreenLight laser photoselective vaporization (PVP) in patients with large prostates for the treatment of benign prostatic hyperplasia (BPH). The data showed that GreenLight PVP was safe and effective in these patients.

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. These patients often experience lower urinary tract symptoms (LUTS). These include symptoms such as difficulties emptying the bladder, urine leakage (incontinence), or getting up to urinate during the night. Standard treatments for BPH involve surgical procedures and medications that can often impact ejaculation and sexual function.

Transurethral resection of the prostate (TURP) is the most common surgery used to treat BPH. TURP involves removing some excess prostate tissue to reduce pressure on the urethra (the tube which carries urine from the bladder to outside the body). With very large prostates, TURP carries an increased risk of side effects, such as bleeding or sexual dysfunction.

Studies have shown that newer laser technologies like GreenLight PVP may be associated with better functional outcomes. GreenLight PVP is the use of a more powerful laser to remove excess prostate tissue through the urethra. However, the outcomes of GreenLight laser PVP in patients with large prostates for the treatment of BPH are still unclear.

This study involved 3426 patients with BPH. Patients were divided into two groups. Group 1 included 1187 men who had a large prostate size (80 cc or more). Group 2 included 2239 men who had a small prostate size (less than 80 cc). All patients received treatment with GreenLight PVP. The International Prostate Symptom Score (IPSS) was measured before and after treatment. This questionnaire can be used to screen for, rapidly diagnose, and track the symptoms of LUTS. Quality of life (QoL), erectile function, maximum urine flow rate, and the volume of urine left in the bladder after urination were also measured.

After 12 months of follow-up, patients in group 1 had significantly lower (better) IPSS scores (by ~19 points) compared to patients in group 2.

After 6- and 12 months of follow-up, patients in group 1 had a significantly lower volume of urine left in the bladder after urination compared to patients in group 2.

 There were no significant differences in transfusion need, blood in urine, or readmission to the hospital after 30 days between the two groups.

This study concluded that GreenLight PVP was safe and effective in patients with large prostates for the treatment of BPH.

This study looked back in time at medical records. The follow-up time was too short. Studies with longer follow-up periods are needed.