title: Safety, Perioperative, and Early Functional Outcomes of Vapor Incision Technique Using the GreenLight XPS 180 W System: Direct Comparison with Photoselective Vaporization of the Prostate.
abstract: To compare perioperative parameters, safety, and short-term functional outcomes between GreenLight 180 W-XPS photoselective vaporization of the prostate (PVP) and vapor incision technique (VIT).
  
  
  
  A total of 956 men were treated at five high-volume centers in Canada and the United States between 2000 and 2014 for benign prostatic hyperplasia. Perioperative parameters, complications, and early functional outcomes were retrospectively compared. One-to-one propensity score matching was performed to adjust for baseline differences between treatment groups. Subgroup stratified comparative analysis was performed according to preoperative prostate volume 80 cc or less vs greater than 80 cc on transrectal ultrasound (259 and 185 patients, respectively).
  
  
  
  VIT allowed greater energy delivery and energy density, but operative time and laser time were longer with greater use of MoXy fibers when compared with PVP (all p < 0.05). Improvements in outcomes at 6 months, including International Prostate Symptom Score, quality of life score, and uroflowmetry parameters, were significantly greater after VIT when compared with baseline. VIT was associated with significantly greater 6-month prostate-specific antigen (PSA) reduction (63% vs 50%, p = 0.01). No differences in intraoperative complications were observed between treatment groups.
  
  
  
  VIT is safe and efficacious, providing greater improvements in functional outcomes and PSA reduction at 6 months in comparison with PVP. These results reflect the larger amount of adenoma removed. Yet, it is associated with longer operative time and greater use of MoXy fibers. Long-term follow-up is needed to accurately assess functional outcomes and retreatment rates.
authors.affiliation: 1 Section of Urology, Department of Surgery, University of Montreal Health Centre , Montreal, Canada .
authors.forename: Mounsif
authors.initials: M
authors.lastname: Azizi
authors.affiliation: 2 Faculty of Medicine, McGill University , Montreal, Canada .
authors.forename: Côme
authors.initials: C
authors.lastname: Tholomier
authors.affiliation: 1 Section of Urology, Department of Surgery, University of Montreal Health Centre , Montreal, Canada .
authors.forename: Malek
authors.initials: M
authors.lastname: Meskawi
authors.affiliation: 1 Section of Urology, Department of Surgery, University of Montreal Health Centre , Montreal, Canada .
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Hueber
authors.affiliation: 1 Section of Urology, Department of Surgery, University of Montreal Health Centre , Montreal, Canada .
authors.forename: Roger F
authors.initials: RF
authors.lastname: Valdivieso
authors.affiliation: 3 Department of Urology, Taibah University , Madina, Saudi Arabia .
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Alenizi
authors.affiliation: 3 Department of Urology, Taibah University , Madina, Saudi Arabia .
authors.forename: Emad
authors.initials: E
authors.lastname: Rajih
authors.affiliation: 1 Section of Urology, Department of Surgery, University of Montreal Health Centre , Montreal, Canada .
authors.forename: Marc
authors.initials: M
authors.lastname: Zanaty
authors.affiliation: 4 Department of Urology, Comprehensive Urology , Westland, Michigan.
authors.forename: Mahmood A
authors.initials: MA
authors.lastname: Hai
authors.affiliation: 5 Department of Urology, Houston Metro Urology , Houston, Texas.
authors.forename: Ricardo R
authors.initials: RR
authors.lastname: Gonzalez
authors.affiliation: 6 Department of Urology, Urology of Virginia , Virginia Beach, Virginia.
authors.forename: Gregg R
authors.initials: GR
authors.lastname: Eure
authors.affiliation: 7 North Fulton Urology PC , Georgia Urology, Roswell, Georgia .
authors.forename: Lewis S
authors.initials: LS
authors.lastname: Kriteman
authors.affiliation: 8 Service d'Urologie , Clinique Pasteur, Toulouse, France .
authors.forename: Vincent
authors.initials: V
authors.lastname: Misrai
authors.affiliation: 1 Section of Urology, Department of Surgery, University of Montreal Health Centre , Montreal, Canada .
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Zorn
mesh_terms: D000368:Aged; D002170:Canada; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007834:Lasers; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D061214:Patient Safety; D059035:Perioperative Period; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014835:Volatilization
chemical_list: D017430:Prostate-Specific Antigen
keywords: benign prostatic hyperplasia; laser; prostate