https://doi.org/10.4081/aiua.2023.11101

Safety profile of treatment with greenlight versus Thulium Laser for benign prostatic hyperplasia

Vol. 95 No. 1 (2023)
Submitted: December 19, 2022
Accepted: December 31, 2022
Published: February 22, 2023
Benign Prostatic Hyperplasia, Complications, GreenLight Laser, Learning curve, Safety, Thulium Laser
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Authors

Davide Campobasso
d.campobasso@virgilio.it
https://orcid.org/0000-0003-2072-114X
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla; Department of Urology, University Hospital of Parma, Italy.
Antonio Barbieri
Department of Urology, University Hospital of Parma, Italy.
Tommaso Bocchialini
Department of Urology, University Hospital of Parma, Italy.
Gian Luigi Pozzoli
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla, Italy.
Francesco Dinale
Department of Urology, University Hospital of Parma, Italy.
Francesco Facchini
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla, Italy.
Marco Serafino Grande
https://orcid.org/0000-0001-5497-4722
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla, Italy.
Jean Emmanuel Kwe
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla; Urological Residency School Network, Department of Urology, University Hospital of Modena and Reggio Emilia, Modena, Italy.
Michelangelo Larosa
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla, Italy.
Giulio Guarino
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla; Urological Residency School Network, Department of Urology, University Hospital of Modena and Reggio Emilia, Modena, Italy.
Davide Mezzogori
Department of Engineering and Architecture, University of Parma, Italy.
Elisa Simonetti
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla, Italy.
Francesco Ziglioli
https://orcid.org/0000-0002-3066-9798
Department of Urology, University Hospital of Parma, Italy.
Antonio Frattini
Department of Urology, Ospedale Civile di Guastalla and Ospedale Ercole Franchini di Montecchio Emilia, Guastalla, Italy.
Umberto Vittorio Maestroni
Department of Urology, University Hospital of Parma, Italy.

Objective: The major strengths of surgical treatment of benign prostatic hyperplasia with laser are reduced morbidity compared to endoscopic resection. No studies analysed the different risk of intra/peri-operative events between patients undergoing Thulium and GreenLight procedures.

Materials and methods: We retrospectively reviewed 100 consecutive cases undergoing GreenLight vaporization and Thulium procedures performed during the learning curve of two expert endoscopic surgeons. Pre-operative data, intra and post-operative events at 90 days were analysed.

Results: Patients on antiplatelet/anticoagulant therapy were pre-dominant in the Green group (p < 0.0001). Rates of blood transfusion (p < 0.0038), use of resectoscope (p < 0.0086), and transient stress urinary incontinence were statistically higher in the Thulium group. On the contrary conversions to TURP (p < 0.023) were more frequent in GreenLight patients. Readmissions were more frequently necessary in GreenLight group (24%) vs. Thulium group (26.6%). The overall complication rate in GreenLight and Thulium groups were 31% and 53% respectively; Clavien 3b complications were 13% in Thulium patients versus 1% in GreenLight patients.

Conclusions: GreenLight and Thulium treatments show similar safety profiles. Randomized controlled trial are needed to better clarify the rate of major complications in Thulium group, and the incidence of post-operative storage symptoms in these patients’ populations.

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Crossref
Scopus
Google Scholar
Europe PMC
Gravas S, Cornu JN, Gacci M, et al. EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). Edn. presented at the EAU Annual Congress Amsterdam 2020. ISBN 978-94-92671-07-3. EAU Guidelines Office, Arnhem, The Netherlands. http://uroweb.org/guidelines/compilations-of-all-guidelines/
Fallara G, Capogrosso P, Schifano N, et al. Ten-year Follow-up Results After Holmium Laser Enucleation of the Prostate. Eur Urol Focus. 2021; 7:612-617. DOI: https://doi.org/10.1016/j.euf.2020.05.012
Campobasso D, Marchioni M, De Nunzio C, et al. Predictors of re-intervention after greenlight laser photoselective vaporization of the prostate: multicenter long/mid-term follow-up experience. Mini-invasive Surgery. 2021; 5:45. DOI: https://doi.org/10.20517/2574-1225.2021.92
Castellani D, Pirola GM, Pacchetti A, et al. State of the Art of Thulium Laser Enucleation and Vapoenucleation of the Prostate: A Systematic Review. Urology. 2020; 136:19-34. DOI: https://doi.org/10.1016/j.urology.2019.10.022
Enikeev D, Morozov A, Taratkin M, et al. Systematic review of the endoscopic enucleation of the prostate learning curve. World J Urol. 2021; 39:2427-2438. DOI: https://doi.org/10.1007/s00345-020-03451-1
Naspro R, Gomez Sancha F, Manica M, et al. From "gold stan-dard" resection to reproducible "future standard" endoscopic enucle-ation of the prostate: what we know about anatomical enucleation. Minerva Urol Nefrol. 2017; 69:446-458. DOI: https://doi.org/10.23736/S0393-2249.17.02834-X
Campobasso D, Ferrari G, Frattini A. Greenlight laser: a laser for every prostate and every urologist. World J Urol. 2022; 40:295-296. DOI: https://doi.org/10.1007/s00345-020-03499-z
Cindolo L, Ruggera L, Destefanis P, et al. Vaporize, anatomically vaporize or enucleate the prostate? The flexible use of the GreenLight laser. Int Urol Nephrol. 2017; 49:405-411. DOI: https://doi.org/10.1007/s11255-016-1494-6
Mamoulakis C, Efthimiou I, Kazoulis S, et al. The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol. 2011; 29:205-210. DOI: https://doi.org/10.1007/s00345-010-0566-y
Leonardo C, Lombardo R, Cindolo L, et al. What is the standard surgical approach to large volume BPE? Systematic review of existing randomized clinical trials. Minerva Urol Nefrol. 2020; 72:22-29. DOI: https://doi.org/10.23736/S0393-2249.19.03589-6
Castellani D, Di Rosa M, Gasparri L, et al. Thulium Laser Vapoenucleation of the Prostate (ThuVEP) in Men at High Cardiovascular Risk and on Antithrombotic Therapy: A Single-Center Experience. J Clin Med. 2020; 9:917. DOI: https://doi.org/10.3390/jcm9040917
Meskawi M, Hueber PA, Valdivieso R, et al. Complications and functional outcomes of high-risk patient with cardiovascular disease on antithrombotic medication treated with the 532-nm-laser photo-vaporization Greenlight XPS-180 W for benign prostate hyperplasia. World J Urol. 2019; 37:1671-1678. DOI: https://doi.org/10.1007/s00345-018-2560-8
Campobasso D, Marchioni M, Altieri V, et al. GreenLight Photoselective Vaporization of the Prostate: One Laser for Different Prostate Sizes. J Endourol. 2020; 34:54-62. DOI: https://doi.org/10.1089/end.2019.0478
Campobasso D, Acampora A, De Nunzio C, et al. Post-Operative Acute Urinary Retention After Greenlight Laser. Analysis Of Risk Factors from A Multicentric Database. Urol J. 2021; 18:693-698.
Mattevi D, Luciani L, Spina R, et al. Comparison of GreenLight 180-W XPS laser vaporization versus transurethral resection of the prostate: Outcomes of a single regional center. Arch Ital Urol Androl. 2020; 92:169-172 DOI: https://doi.org/10.4081/aiua.2020.3.169
Castellucci R, Marchioni M, Fasolis G, et al. The safety and fea-sibility of the simultaneous use of 180-W GreenLight laser for prostate vaporization during concomitant surgery. Arch Ital Urol Androl. 2020; 92:297-301 DOI: https://doi.org/10.4081/aiua.2020.4.297
Elmansy H, Hodhod A, Elshafei A, et al. Comparative analysis of MOSESTM technology versus novel thulium fiber laser (TFL) for transurethral enucleation of the prostate: A single-institutional study. Arch Ital Urol Androl. 2022; 94:180-185. DOI: https://doi.org/10.4081/aiua.2022.2.180
Palmero-Martí JL, Panach-Navarrete J, Valls-González L, et al. Comparative study between thulium laser (Tm: YAG) 150W and greenlight laser (LBO:ND-YAG) 120W for the treatment of benign prostatic hyperpplasia: Short-term efficacy and security. Actas Urol Esp. 2017; 41:188-193. DOI: https://doi.org/10.1016/j.acuroe.2017.02.007
Castellani D, Cindolo L, De Nunzio C, et al. Comparison Between Thulium Laser VapoEnucleation and GreenLight Laser Photoselective Vaporization of the Prostate in Real-Life Setting: Propensity Score Analysis. Urology. 2018; 121:147-152. DOI: https://doi.org/10.1016/j.urology.2018.09.007
Cindolo L, De Nunzio C, Greco F, et al. Standard vs. anatomical 180-W GreenLight laser photoselective vaporization of the prostate: a propensity score analysis. World J Urol. 2018; 36:91-97. DOI: https://doi.org/10.1007/s00345-017-2106-5
Kyriazis I, Swiniarski PP, Jutzi S, et al. Transurethral anatomical enucleation of the prostate with Tm:YAG support (ThuLEP): Review of the literature on a novel surgical approach in the management of benign prostatic enlargement. World J Urol. 2015; 33:525-30. DOI: https://doi.org/10.1007/s00345-015-1529-0

How to Cite

Campobasso, D., Barbieri, A., Bocchialini, T., Pozzoli, G. L., Dinale, F., Facchini, F., Grande, M. S., Kwe, J. E., Larosa, M., Guarino, G., Mezzogori, D., Simonetti, E., Ziglioli, F., Frattini, A., & Maestroni, U. V. (2023). Safety profile of treatment with greenlight versus Thulium Laser for benign prostatic hyperplasia. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11101
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