title: GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: a randomized clinical trial with 2-year follow-up.
abstract: BACKGROUND
  High-level evidence to support the use of photoselective vaporization of the prostate (PVP) is limited.
  
  
  OBJECTIVE
  Assess the efficacy and safety of GreenLight HPS 120-W laser PVP compared with transurethral resection of the prostate (TURP).
  
  
  METHODS
  A randomized clinical trial was performed with 50 patients having lower urinary tract symptoms due to benign prostatic hyperplasia in each treatment arm.
  
  
  METHODS
  Random allocation to PVP or TURP.
  
  
  METHODS
  International Prostate Symptom Score (IPSS), quality of life (QoL), and changes in maximum flow rate (Qmax) were the main end points. Patients were evaluated at a follow-up time of 2 yr. Five patients were lost to follow-up. A last observation carried forward analysis was done.
  
  
  CONCLUSIONS
  Both laser PVP and TURP resulted in the same IPPS reduction at 2 yr (-15.7 and -14.9, respectively; p=0.48) and in the same gain in Qmax (+14.5 ml/s and +13.1 ml/s, respectively; p=0.65). QoL was equivalent for both treatment modalities. These results were independent of prostate size, American Society of Anesthesiologists risk category, and prior indwelling catheter. No statistically significant differences were detected between arms in terms of complication rates. In the laser PVP group, three patients were readmitted to the hospital and two developed a urethral stricture. In the TURP group, two patients were readmitted, six developed a urethral stricture, and two developed bladder neck sclerosis. In-hospital stay and time to catheter removal were significantly shorter with PVP. Limitations are the potential lack of power to detect differences in the complications between groups and the lack of blindness due to the nature of the intervention.
  
  
  CONCLUSIONS
  GreenLight HPS 120-W laser PVP is as effective as TURP for symptom reduction and improvement of QoL. No differences were seen in the response of storage and voiding symptoms. Laser PVP and TURP have the same complication rate. Length of stay is shorter for laser PVP group.
authors.affiliation: Department of Urology, Hospital Universitario Fundacion Alcorcon, Universidad Rey Juan Carlos, Madrid, Spain. ccapitan@fhalcorcon.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Capitán
authors.forename: Cristina
authors.initials: C
authors.lastname: Blázquez
authors.forename: M Dolores
authors.initials: MD
authors.lastname: Martin
authors.forename: Virginia
authors.initials: V
authors.lastname: Hernández
authors.forename: Enrique
authors.initials: E
authors.lastname: de la Peña
authors.forename: Carlos
authors.initials: C
authors.lastname: Llorente
mesh_terms: D000368:Aged; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D059012:Lost to Follow-Up; D059411:Lower Urinary Tract Symptoms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011467:Prostate / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000601:surgery*; D011788:Quality of Life; D012720:Severity of Illness Index; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome