title: The effect of increased maximum power output on perioperative and early postoperative outcome in photoselective vaporization of the prostate.
abstract: OBJECTIVE
  Preclinical studies suggest an increased vaporization rate and speed of the 532 nm 180-W XPS GreenLight laser (180-W) compared with the 120-W HPS GreenLight laser (120-W) and the 80-W PV GreenLight laser (80-W). To test the clinical relevance of this observation we analyzed intraoperative data and early postoperative results after photoselective vaporization of the prostate (PVP) with the 180-W, 120-W, and 80-W laser.
  
  
  METHODS
  A retrospective pair-to-pair comparison was performed including 80 consecutive patients who underwent PVP for the treatment of benign prostate enlargement with the 180-W, 120-W, and 80-W laser. The groups matched concerning age, prostate volume, PSA-value, and preoperative catheterization. Primary study outcome measurement was PSA-value reduction at 3 months; intraoperative data, perioperative complications, and early postoperative functional course were secondary study outcome measurements.
  
  
  RESULTS
  Energy application per case (kJ), preoperative prostate volume (kJ/ml) operating time (kJ/minute), and lasing time (kJ/minute) was significantly higher with the 180-W laser. Prevalence of impaired visibility due to bleeding was comparable between the 180-W and the 120-W laser but significantly lower with 80-W. Duration of hospitalization was shorter with the 180-W laser compared to the former laser systems. During the postoperative course of 3 months voiding parameters and micturition symptoms significantly improved in all groups, the incidence of postoperative dysuria was comparable. Postoperative PSA-value reduction was significantly higher after treatment with the 180-W laser.
  
  
  CONCLUSIONS
  With the 180-W laser, higher energy application and higher speed of tissue vaporization leads to increased tissue vaporization compared to the former 120-W and 80-W laser systems. Clinical efficacy and perioperative safety are maintained with the higher powered laser.
authors.affiliation: Department of Urology, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland. mrieken@uhbs.ch
authors.forename: Malte
authors.initials: M
authors.lastname: Rieken
authors.forename: Gernot
authors.initials: G
authors.lastname: Bonkat
authors.forename: Georg
authors.initials: G
authors.lastname: Müller
authors.forename: Stephen
authors.initials: S
authors.lastname: Wyler
authors.forename: Nicole Ebinger
authors.initials: NE
authors.lastname: Mundorff
authors.forename: Heike
authors.initials: H
authors.lastname: Püschel
authors.forename: Thomas
authors.initials: T
authors.lastname: Gasser
authors.forename: Alexander
authors.initials: A
authors.lastname: Bachmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006760:Hospitalization; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D011470:Prostatic Hyperplasia / Q000150:complications / Q000473:pathology / Q000628:therapy*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome