Reviewing effectiveness and safety of greenlight photo-selective vaporization of the prostate in patients with benign prostatic hyperplasia.

This study characterized the safety and effectiveness of greenlight photo-selective vaporization of the prostate (GL-PVP) in the treatment of benign prostatic hyperplasia (BPH). The data showed that under real-world conditions, GL-PVP provides a safe, effective, and durable BPH treatment option.

Lower urinary tract symptoms (LUTS) commonly occur in men with BPH. The standard treatment is a surgery called transurethral resection of the prostate (TURP). However, bleeding is common with TURP. Minimally invasive techniques such as GL-PVP are alternatives to TURP.

GL-PVP involves the use of a laser to vaporize excessive tissue in enlarged prostates. Compared to TURP, GL-PVP results in minimal bleeding. There is a need to determine the current, global state of GL-PVP by data collection from international centers through the Global Greenlight Group (GGG) database.

This study analyzed data from 3627 patients with LUTS secondary to BPH. All patients underwent GL-PVP using the XPS-180 W system. Data were evaluated up to 60 months.

The average prostate-specific antigen (PSA; a protein made by the prostate gland) level was 3.1 ng/mL. On average, there was a 43.9% PSA reduction at 3 months and a 46.4 % reduction at 60 months, after the procedure. The average time of the procedure was 34 minutes. In 60.1% of patients, the catheter was removed one day after the procedure. 

Significant improvements in urinary symptoms and quality of life were seen at all timepoints during follow-up.

Most side effects were mild. 1.7% of patients experienced moderate and severe complications. 13.2% of patients had emergency room visits due to bloody urine. 10.5% of patients had urine leakage and 22.5% had urinary symptoms in the first month. After 6 months, 0.7% had urine leakage and 2.8% had urinary symptoms. 

The study showed that GL-PVP is a safe and effective treatment alternative for LUTS secondary to BPH.

The study design did not allow certain types of data to be collected and longer follow-ups are needed.