In a nutshell
This study reviewed recently published evidence on the GreenLight laser procedure in the treatment of men with different prostate sizes.
The authors concluded that outcomes of the GreenLight procedure are similar in large and small prostates.
Some background
The GreenLight procedure is a well-tolerated and effective surgical technique to treat benign prostatic hyperplasia (BPH). It involves the destruction of enlarged prostate tissue by high-intensity pulses of light that are passed through a fiber inserted into the urethra (the penile opening). It is a less invasive alternative to other surgical standard-of-care procedures. However, evidence is mixed regarding its effectiveness for treating very large prostates (larger than 80-100 mL).
Methods & findings
This article reviewed recently published evidence on the effect of prostate size on outcomes of the GreenLight procedure. Seven separate clinical trials, involving a combined total of 1,679 men with BPH, were included in this review.
Across these studies, there were no differences between men with smaller prostates (smaller than 80 mL) and men with larger prostates (larger than 80 mL) in treatment effectivity. Urinary symptoms, prostate-specific antigen levels and quality of life were similarly improved in both groups. This was maintained during all follow-up time points, the longest being 2 years after procedure.
Larger prostates were, on average, associated with longer procedure times and more energy needed to remove the enlarged tissue. Importantly, prostate size did not affect the length of time spent in hospital after the procedure. The amount of time men required the use of a urinary catheter after the procedure was also unchanged. Most patients, regardless of prostate size, were discharged within 24 hours.
The rate of complications was low for both small and large prostates. However, the need for surgical retreatment (an additional procedure) increased with prostate size, with 9% to 16% of patients with large prostates requiring additional treatment within 1 to 2 years after the procedure. This may be related to not enough energy being delivered during the GreenLight procedure in cases of large prostates.
The bottom line
This review article concluded that the GreenLight procedure is a safe and effective treatment of prostate enlargement regardless of prostate size. It can, therefore, be considered as a possible alternative to other surgical procedures, even for very large prostates.
Published By :
Current opinion in urology
Date :
Jan 01, 2016
