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Learning curves and perioperative outcomes after endoscopic enucleation of the prostate: A comparison between GreenLight 532-nm and holmium lasers

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Sources of Funding: none

Introduction

Studies comparing learning curves and outcomes after HoLEP compared to other endoscopic enucleation techniques are lacking. None have assessed the learning curve of Greelight Laser enucleation of the prostate (GreenLEP). The aim of this study was to compare the learning curves and the perioperative and early functional outcomes of GreenLEP to those of HoLEP

Methods

Data from the first 100 consecutive cases treated by GreenLEP and HoLEP by two surgeons were prospectively collected from dedicated databases and analysed retrospectively. En-bloc GreenLEP and two-lobar HoLEP enucleations were conducted using the GreenLight HPS™ 2090 laser and Lumenis™ Holmium laser. Patients’ characteristics, perioperative outcomes and functional outcomes after 1, 3 and 6 months were compared between groups.

Results

Total energy delivered and operative times were significantly shorter for GreenLEP (58 vs 110 kJ, p<0.0001; 60 vs 90 min, p<0.0001). Operative time reached a plateau after 30 procedures in each group. Length of catheterization and hospital stay were significantly shorter in the HoLEP group (2 vs 1 day, p<0.0001; 2 vs 1 day, p<0.0001). Postoperative complications were comparable between GreenLEP and HoLEP (19% vs 25%; p=0.13). There was a greater increase of Qmax at 3 months and a greater IPSS decrease at 1 month for GreenLEP, whereas decreases in IPSS and IPSS-Q8 at 6 months were greater for HoLEP. Transient stress urinary incontinence was comparable between both groups (6% vs 9% at 3 months; p=0.42). Pentafecta was achieved in four consecutive patients after the 18th and the 40th procedure in the Greenlep and HoLEP group respectively. Learning curves ranged from 14–30 cases for GreenLEP and 22–40 cases for HoLEP.

Conclusions

Learning curves of GreenLEP and HoLEP provided roughly similar peri-operative and short-term functional outcomes.

Funding

none

Authors
benoit peyronnet
grégoire robert
vincent comat
morgan roupret
fernando gomez-sancha
jean-nicolas cornu
vincent misrai
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