Introduction

To assess perioperative outcomes and short term results after Photoselective vaporization of the prostate (PVP), laser enucleation of the prostate (GreenLEP) with Greenlight and standard open prostatectomy (OP) in patients with enlarged prostate glands and LUTS related to benign prostatic obstruction.

Methods

From January 2012 to September 2015, data from 1034 patients treated with PVP, GreenLEP and OP at two institutions were collected. Perioperative data and short term results including uroflowmetry measures and International Prostate Symptom Score (IPSS) were collected. Patients with prostate glands ≥ 80ml and LUTS related to BPH were retrospectively included in the analysis. Patients were matched and three groups of 50 patients treated with PVP, GreenLEP or OP were compared._x000D_

Results

Mean prostate volume was comparable in the three groups (120 vs 120.5 vs 122.2 mL, p=0.952, respectively) . A longer operative time, a lower rate of postoperative bleeding complications (p=0.018) and a shorter length of bladder irrigation (p<0.001), catheterization (p<0.001) and hospital stay (p<0.001) were observed in PVP and GreenLEP groups(Table 1 & 2). At 3 and 12 months, PVP was associated with a lower maximal urinary flow and a higher IPSS than OP and GreenLEP (p<0.001, p=0.025 and p=0.020, respectively) (Figure 1). Patients treated with PVP had a higher risk of re-treatment than those treated with GreenLEP or OP (log rank test: p=0.059).

Conclusions

PVP and GreenLEP are associated with longer operative time but better post-operative outcomes than OP. However, regarding functional outcomes, PVP might be less effective than OP and GreenLEP in prostate glands over 80mL.

Funding

none