Objective: To evaluate the clinical effect and safety of transurethral 180 W front-firing GreenLight laser vaporization of the prostate (PVP) in the treatment of benign prostatic hyperplasia (BPH).
Methods: A total of 61 BPH patients underwent 180W front-firing GreenLight laser PVP (n = 30, the PVP group) or transurethral plasmakinetic resection of the prostate (n = 31, the control group) from March to December 2019. We collected the pre-, intra- and post-operative clinical data and compared them between the two groups of patients.
Results: Operations were successfully completed in all the cases with no blood transfusion or serious complications. Compared with the controls, the patients of the PVP group showed remarkably less intra-operative blood loss (［62.3 ± 15.9］ vs ［48.8 ± 9.6］ ml, P < 0.05), shorter operation time (［75.0 ± 9.9］ vs ［57.5 ± 19.0］ min, P < 0.05), postoperative bladder lavage time (［64.4 ± 10.5］ vs ［25.2 ± 11.5］ h, P < 0.05), catheter-indwelling time (［5.1 ± 0.5］ vs ［2.5 ± 0.5］ d, P < 0.05) and hospitalization time (［7.3 ± 1.7］ vs ［4.1 ± 0.6］ d, P < 0.05), and a lower incidence of postoperative hematuria (12.9% ［4/31］ vs 0% ［0/30］, P < 0.05). No statistically significant differences, however, were found between the two groups in the incidence rates of capsular perforation, transurethral resection syndrome (TURS), urinary incontinence, urethral stricture and post-extubation urinary retention. Significant improvement was observed in IPSS, QOL, Qmax and PVR in both groups post-operatively (P < 0.05).
Conclusions: Compared with transurethral plasmakinetic resection of the prostate, 180W front-firing GreenLight laser PVP, with the advantages of less bleeding, shorter catheter-indwelling time and faster recovery, is safer and more effective for the treatment of BPH, with no need for drug withdrawal for those taking anticoagulants, and especially applicable to the elderly and high-risk patients.
Keywords: front-firing GreenLight laser vaporization of the prostate; transurethral plasmakinetic resection of the prostate; benign prostatic hyperplasia.