title: Mid term outcomes of initial 250 case experience with GreenLight 120W-HPS photoselective vaporization prostatectomy for benign prostatic hyperplasia: comparison of prostate volumes < 60 cc, 60 cc-100 cc and > 100 cc.
abstract: BACKGROUND
  The aim of this study was to compare the efficacy of GreenLight 120W-HPS (American Medical Systems, Minnetonka, Minnesota, USA) laser vaporization for men with obstructive benign prostatic hyperplasia (BPH) according to prostate volumes < 60 cc, 60 cc-100 cc and > 100 cc.
  
  
  METHODS
  The clinical data of 250 men with symptomatic BPH who underwent photoselective vaporization prostatectomy (PVP) by a single surgeon between July 2007 and August 2009 were retrospectively analyzed. Prostate volumes were measured by using transrectal ultrasonography (TRUS). Functional evaluations were performed at 3, 6 and 12 months with a prostate-specific antigen (PSA) obtained at 6 months. All men were stratified into three groups according to TRUS volume.
  
  
  RESULTS
  Among the 250 consecutive PVP patients, 134, 76 and 40 men had prostate volumes < 60 cc, 60 cc-100 cc and > 100 cc, respectively. Mean laser time and delivered energy were 31, 44 and 59 minutes; 163, 309 and 473 kJ respectively (p < 0.01 for all). At 1 year, mean International Prostate Symptom Score (IPSS) improved by 69%, 63% and 50%, Qmax increased by 194%, 175% and 162% and post void residual (PVR) decreased by 88%, 81% and 71%, respectively (p < 0.01 for all). Mean decrease in preoperative PSA at 6 months was 63%, 52% and 41% (p < 0.01), respectively. Hospital stay, catheterization time and complication rates were comparable between groups, however retreatment rates were significantly higher for prostates >100 cc (1.5% versus 2.6% versus 9%; p = 0.02).
  
  
  CONCLUSIONS
  Although larger prostates require more time and energy delivery, PVP is safe and efficacious for patients with lower urinary tract symptoms (LUTS) regardless of prostate size. Laser vaporization for glands > 100 cc appears to have a reduced reduction in PSA and a higher 9% rate of retreatment indicating that PVP for larger prostates remains to be optimized.
authors.affiliation: Section of Urology Department of Surgery, Centre Hospitalier de l'Universite de Montréal, Quebec, Canada.
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Hueber
authors.forename: Tal
authors.initials: T
authors.lastname: Ben-Zvi
authors.forename: Daniel
authors.initials: D
authors.lastname: Liberman
authors.forename: Naeem
authors.initials: N
authors.lastname: Bhojani
authors.forename: Gagan
authors.initials: G
authors.lastname: Gautam
authors.forename: Tom
authors.initials: T
authors.lastname: Deklaj
authors.forename: Mark
authors.initials: M
authors.lastname: Katz
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Zorn
mesh_terms: D000368:Aged; D003116:Color; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D007902:Length of Stay; D008027:Light; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography; D016055:Urinary Retention / Q000209:etiology / Q000601:surgery
chemical_list: D017430:Prostate-Specific Antigen