title: Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia Using the 180 Watt System: Multicenter Study of the Impact of Prostate Size on Safety and Outcomes.
abstract: OBJECTIVE
  We evaluated photoselective vaporization of the prostate using the GreenLight™ XPS™ 180 W system for benign prostatic hyperplasia treatment in a large multi-institutional cohort at 2 years. We particularly examined safety, outcomes and the re-treatment rate in larger prostates, defined as a prostate volume of 80 cc or greater, to assess the potential of photoselective vaporization of the prostate as a size independent procedure.
  
  
  METHODS
  A total of 1,196 patients were treated at 6 international centers in Canada, the United States, France and England. All parameters were collected retrospectively, including complications, I-PSS, maximum urinary flow rate, post-void residual urine, prostate volume, prostate specific antigen and the endoscopic re-intervention rate. Subgroup stratified comparative analysis was performed according to preoperative prostate volume less than 80 vs 80 cc or greater on transrectal ultrasound.
  
  
  RESULTS
  Median prostate size was 50 cc in 387 patients and 108 cc in 741 in the prostate volume groups less than 80 and 80 cc or greater, respectively. The rate of conversion to transurethral prostate resection was significantly higher in the 80 cc or greater group than in the less than 80 cc group (8.4% vs 0.6%, p <0.01). I-PSS, quality of life score, maximum urinary flow rate and post-void residual urine were significantly improved compared to baseline at 6, 12 and 24 months of followup without significant differences between the prostate size groups. The re-treatment rate at 2 years reported in 5 of 411 patients was associated with the delivery of decreased energy density (2.1 vs 4.4 kJ/cc) in the group without re-treatment.
  
  
  CONCLUSIONS
  Photoselective vaporization of the prostate using the XPS 180 W system is safe and efficacious, providing durable improvement in functional outcomes at 2 years independent of prostate size when treated with sufficient energy.
authors: Section of Urology, Department of Surgery, University of Montreal Hospital Center, Université de Montréal, Montreal, Quebec, Canada.
authors: Pierre-Alain
authors: PA
authors: Hueber
authors: Section of Urology, Department of Surgery, University of Montreal Hospital Center, Université de Montréal, Montreal, Quebec, Canada.
authors: Marc Nicolas
authors: MN
authors: Bienz
authors: Section of Urology, Department of Surgery, University of Montreal Hospital Center, Université de Montréal, Montreal, Quebec, Canada.
authors: Roger
authors: R
authors: Valdivieso
authors: Section of Urology, Department of Surgery, University of Montreal Hospital Center, Université de Montréal, Montreal, Quebec, Canada.
authors: Hugo
authors: H
authors: Lavigueur-Blouin
authors: Department of Urology, Clinique Pasteur Toulouse, Toulouse, France.
authors: Vincent
authors: V
authors: Misrai
authors: Department of Urology, Columbia University, New York, New York.
authors: Matthew
authors: M
authors: Rutman
authors: Department of Urology, Cornell University, New York, New York.
authors: Alexis E
authors: AE
authors: Te
authors: Department of Urology, Cornell University, New York, New York.
authors: Bilal
authors: B
authors: Chughtai
authors: Department of Urology, Frimley Park Hospital, Frimley, United Kingdom.
authors: Neil J
authors: NJ
authors: Barber
authors: Department of Urology, Frimley Park Hospital, Frimley, United Kingdom.
authors: Amr M
authors: AM
authors: Emara
authors: Department of Urology, Hackensack University Medical Center, New Jersey.
authors: Ravi
authors: R
authors: Munver
authors: Center for Surgery and Public Health and Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors: Quoc-Dien
authors: QD
authors: Trinh
authors: Section of Urology, Department of Surgery, University of Montreal Hospital Center, Université de Montréal, Montreal, Quebec, Canada. Electronic address: zorn.chumurology@gmail.com.
authors: Kevin C
authors: KC
authors: Zorn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019160:Endosonography / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging*; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D011788:Quality of Life; D012007:Rectum; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D014835:Volatilization
keywords: laser therapy; organ size; prostate; prostatic hyperplasia; volatilization