title: Does prostate size impact upon perioperative outcomes associated with photoselective vaporization of the prostate using the 180W lithium triborate laser?
abstract: BACKGROUND
  Photoselective vaporization of the prostate (PVP) has been widely adopted as a surgical treatment for lower urinary tract symptoms due to benign prostatic hyperplasia (BPH). Recently, a high-powered 180 W lithium triborate (LBO) laser has become commercially available and there is relatively little information on the impact of this very high-powered laser on perioperative outcomes. Even more so is the impact of the laser on outcomes according to prostate size.
  
  
  OBJECTIVE
  The objective of this study was to evaluate perioperative outcomes after PVP with the 180W laser, relative to prostate size.
  
  
  METHODS
  A prospectively maintained institutional ethics approved database was retrospectively reviewed. Subjects were analyzed according to transrectal ultrasound and categorized into groups namely 0-39 mL, 40-79 mL, 80-120 mL and >120 mL. Perioperative measures included energy utilized, length of operation, duration catheterization, post operative length of stay (POLOS), Clavien-Dindo adverse events and number discharged home within 24 hours catheter free.
  
  
  RESULTS
  With increasing prostate size, there was a statistically significant increase in energy utilization and operation time (P < 0.01 between groups). Duration of catheterization, POLOS, incidence of Grade 3 and above Clavien-Dindo adverse events and discharge home catheter free within 24 hours was not statistically significant across groups.
  
  
  CONCLUSIONS
  Prostate volume impacts upon energy utilized with PVP surgery. Prostate volume does not influence duration of catheterization or POLOS. Clavien-Dindo Grade 3 or greater adverse events were low and do not appear to be influenced by prostate size. The ability to be discharged home catheter free within 24 hours likewise does not appear to be influenced by prostate size.
authors: Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, Australia.
authors: Kellie E
authors: KE
authors: West
authors: Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, Australia.
authors: Henry H
authors: HH
authors: Woo
keywords: Benign prostatic hyperplasia; laser prostatectomy; photoselective vaporization prostate
references: Eur Urol. 2012 Jun;61(6):1174-6; discussion 1176-7
references: 22386836
references: Eur Urol. 2014 May;65(5):931-42
references: 24331152
references: ANZ J Surg. 2012 May;82(5):334-7
references: 22507245
references: BJU Int. 2011 Sep;108(6):860-3
references: 21105987
references: Prostate Int. 2013;1(1):42-5
references: 24223401
references: Curr Opin Urol. 2012 Jan;22(1):22-33
references: 22123291
references: Eur Urol. 2012 Mar;61(3):600-7
references: 22153927
references: Eur Urol. 2012 Aug;62(2):315-23
references: 22575913