Introduction

Assessment of the learning curve, perioperative morbidity and functional outcome of endoscopic enucleation of the prostate with 532nm Green laser (GreenLEP) compared to Holmium laser system (HoLEP) in the surgical treatment of Lower Urinary Tract Symptoms (LUTS) related to Benign Prostate Obstruction (BPO)._x000D_

Methods

From December 2013 to January 2016, 123 patients with LUTS due to BPO underwent endoscopic enucleation of the prostate (67 GreenLEP and 56 HoLEP) in two centers by two surgeons with no previous enucleation experience. Perioperative data (prostate volume, operative times, Clavien-Dindo complications and functional outcomes (IPSS score, Qmax)) were prospectively collected. Statistical analysis retrospectively compared the two surgical techniques. To assess the impact of the learning curve, patients were divided in two groups: group1, the first half of experience and group2, the second half, in each technique (Chi2 test and ANOVA)._x000D_

Results

Mean prostate volumes were 124.2 and 72.3 g in GreenLEP and HoLEP groups, respectively (p<0.001). Mean enucleation and morcellation times were shorter in GreenLEP group (63.5 vs 80.4 min and 0.15 vs 0.24 min/g, p<0.001 and p=0.005, respectively) (Table 1). Operative times were lower in GreenLEP group (0.87 vs 1.6min/g, p<0.001). Ten patients experienced TURP conversion for hemostasis in GreenLEP group (90% in the sub group1), no in HoLEP group (p=0.003). Hospital stay was longer in HoLEP group (4.2 vs 2.5 days, p>0.001). Operative parameters (operative time and hospital stay) were improved in the group1 (p<0.001). Mean IPSS scores were lower in GreenLEP group while post-operative PSA levels were similar (Fig1).

Conclusions

In the learning curve, GreenLEP provides promising results and comparable functional outcomes to HoLEP technique with a possible shorter operative time and hospital stay._x000D_

Funding

None