title: Does size really matter? The impact of prostate volume on the efficacy and safety of GreenLight HPS™ laser photoselective vaporization of the prostate.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of GreenLight HPS™ laser photoselective vaporization of the prostate (PVP) for the treatment of benign prostatic hyperplasia (BPH) in patients with different prostate volumes.
  
  
  METHODS
  Between July 2006 and February 2011, 207 consecutive patients were identified from a prospectively maintained urologic database. Based on preoperative prostate volume measured by transrectal ultrasonography, patients were stratified into two groups: ≥ 80 cc (group 1, n=57) and < 80 cc (group 2, n=150). Transurethral PVP was performed using a 120W GreenLight HPS side-firing laser system. American Urological Association Symptom Score (AUASS), quality-of-life (QoL) score, maximum flow rate (Qmax), and postvoid residual (PVR) volume were measured preoperatively and at 1 and 4 weeks and 3, 6, 12, 18, 24, and 36 months postoperatively.
  
  
  RESULTS
  Among the preoperative parameters evaluated, there were significant differences (P<0.05) in the incidence of preoperative urinary retention (1: 24.6%; 2: 7.3%), serum prostate-specific antigen level (1: 4.5 ± 2.7; 2: 1.8 ± 1.9 ng/mL), QoL (1: 4.2 ± 1.1; 2: 4.7 ± 0.9), and mean prostate volume (1: 118.1 ± 37.9; 2: 48.5 ± 15.5 cc), while AUASS, Qmax, and PVR were similar (P>0.05) between groups. Significant differences (P<0.05) in laser use (1: 22.8 ± 13.3; 2: 10.4 ± 6.4 minutes) and energy usage (1: 152.7 ± 90.6; 2: 70.9 ± 44.8 kJ) were also noted. Clinical outcomes (AUASS, QoL, Qmax, and PVR) showed immediate and stable improvement from baseline (P<0.05) within each group, but no significant differences between the two groups were observed during the follow-up period (P>0.05). The incidence of adverse events was low and similar in both cohorts.
  
  
  CONCLUSIONS
  These results suggest that prostate volume has little effect on the efficacy and safety of GreenLight HPS laser PVP, and that this technique remains a viable surgical option for BPH, irrespective of preoperative prostate volume.
authors: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors: Xiao
authors: X
authors: Gu
authors: Gino J
authors: GJ
authors: Vricella
authors: Massimiliano
authors: M
authors: Spaliviero
authors: Carson
authors: C
authors: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D019990:Perioperative Care; D011467:Prostate / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome