GreenLight laser prostatectomy: a safe and effective treatment for bladder outlet obstruction by prostate cancer.
OBJECTIVE
• To present our experience on photoselective vaporization of the prostate (PVP) in a cohort of men with bladder outlet obstruction (BOO) by prostate cancer.


METHODS
• From 2003 to 2008 we identified 43 patients with prostate cancer treated with PVP. • The patients' hospital records were comprehensively reviewed to obtain preoperative, intra-operative and postoperative data. • Inclusion criteria were patients with BOO or urinary retention with a diagnosis of prostate cancer.


RESULTS
• Mean operating time was 42 min, mean post-operative hospital stay was 9.6 h. 32 out of 43 patients were discharged home within 24 h. Twelve patients (28%) did not need post-operative catheter. Mean and median catheter times were 22 and 21.5 h respectively. • Complications were mild: 1 patient needed bladder irrigation, 3 failed initial TWOC, 1 had early stress incontinence. Three had clot retention. • At 3 months post-operatively, 41 of 42 evaluable patients were voiding without a catheter. The mean peak flow rate had increased by 80% and a mean residual volume decreased of 49%. • Four patients underwent a second laser treatment. Three had developed further retention between 7 and 23 months post-operatively and did not want further surgery. The local failure rate at a mean follow up of 22 months was 7 of 39 patients (18%).


CONCLUSIONS
• The present study is the first on PVP applied to patients with prostate cancer. • It is shown that, for patients with CaP bothered by LUTS or retention, GreenLight laser prostatectomy is very safe and gives excellent relief from symptoms, with a good improvement in peak flow rate.
Urology, King's College Hospital, London, UKUrology, NUI Galway, Galway, Ireland.
Fabiola
F
Liberale
Urology, King's College Hospital, London, UKUrology, NUI Galway, Galway, Ireland.
Gordon Hugh
GH
Muir
Urology, King's College Hospital, London, UKUrology, NUI Galway, Galway, Ireland.
Killian
K
Walsh
Urology, King's College Hospital, London, UKUrology, NUI Galway, Galway, Ireland.
Rajbabu
R
Krishnamoorthy
D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000601:surgery*