The safety and feasibility of the simultaneous use of 180-W GreenLight laser for prostate vaporization during concomitant surgery

Submitted: March 24, 2020
Accepted: August 21, 2020
Published: December 17, 2020
Abstract Views: 715
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Objectives: To explore the safety and feasibility of photo-selective vaporization of the prostate (PVP) with GreenLight XPS 180 Watt laser (GL-180- W XPS) combined with other surgical procedures.
Material and methods: Data on patients in whom GL-180-W XPS was performed to relieve lower urinary tract symptoms/ benign prostatic hyperplasia (LUTS/BPH) symptoms were extracted from a multi-institutional database (2011-2016). Patients were stratified into two groups. In the first all patients who had GL-180-W XPS with a concomitant procedure during the same surgical session were included as cases while those who underwent GL-180-W XPS PVP only were included as control.
Results: A total of 487 patients were included. Fifty-eight (11.9%) patients underwent concomitant procedures. Multivariable linear regression models failed to find an association between concomitant procedures and longer laser time (p = 0.4). Similarly, multivariable linear regression models failed to find an association between concomitant procedures and laser time even when the analyses were repeated and stratified into endoscopic (p = 0.6) and open/laparoscopic (p = 0.4) procedures. Multivariable logistic regression models failed to demonstrate any association between concomitant procedures and early complications (OR:1.39, CI: 0.379-2.44, p = 0.2), late complications (OR:1.84, CI:0.78-3.98; p = 0.1) and acute urinary retention (OR:1.84, CI:0.78-3.98; p = 0.1). When the analyses were repeated and the concomitant procedures stratified into endoscopic and open/laparoscopic ones, they yielded virtually the same results.
Conclusions: GL-180-W XPS PVP could be safely performed in concomitant endoscopic or open/laparoscopic surgery. These results should be taken into consideration in the counseling of the patient who might choose to undergo simultaneous procedures.

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Abrams P, Chapple C, Khoury S, Roehrborn C, de la Rosette J, International Consultation on New Developments in Prostate Cancer and Prostate Diseases. Evaluation and Treatment of Lower Urinary Tract Symptoms in Older Men. J Urol 2013;189:S93–S101. https://doi.org10.1016/j.juro.2012.11.021.
Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003;61:37–49. DOI: https://doi.org/10.1016/S0090-4295(02)02243-4
Cindolo L, Pirozzi L, Sountoulides P, et al. Patient’s adherence on pharmacological therapy for benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS) is different: is combination therapy better than monotherapy? BMC Urol 2015;15:96. https://doi.org10.1186/s12894-015-0090-x. DOI: https://doi.org/10.1186/s12894-015-0090-x
Patel A, Nunez R, Mmeje CO, Humphreys MR. Safety and feasibility of concomitant surgery during holmium laser enucleation of the prostate (HoLEP). World J Urol 2014;32:1543–1549. https://doi.org10.1007/s00345-014-1254-0. DOI: https://doi.org/10.1007/s00345-014-1254-0
Cindolo L, Marchioni M, Emiliani E, et al. Bladder neck contracture after surgery for benign prostatic obstruction. Minerva Urol Nefrol 2017;69:133–143. https://doi.org10.23736/S0393-2249.16.02777-6.
Sountoulides P, Tsakiris P. The Evolution of KTP Laser Vaporization of the Prostate. Yonsei Med J 2008;49:189. https://doi.org10.3349/ymj.2008.49.2.189. DOI: https://doi.org/10.3349/ymj.2008.49.2.189
Ben-Zvi T, Hueber P-A, Liberman D, Valdivieso R, Zorn KC. GreenLight XPS 180W vs HPS 120W Laser Therapy for Benign Prostate Hyperplasia: A Prospective Comparative Analysis After 200 Cases in a Single-center Study. Urology 2013;81:853–858. https://doi.org10.1016/j.urology.2012.12.031. DOI: https://doi.org/10.1016/j.urology.2012.12.031
Castellan P, Castellucci R, Schips L, Cindolo L. Safety, efficacy and reliability of 180-W GreenLight laser technology for prostate vaporization: review of the literature. World J Urol 2015;33:599–607. https://doi.org10.1007/s00345-015-1490-y. DOI: https://doi.org/10.1007/s00345-015-1490-y
Cindolo L, Ingrosso M, Marchioni M, Rizzoli A, Berardinelli F, Schips L. Robot-assisted laparoscopic bladder diverticulectomy and greenlight laser anatomic vaporization of the prostate. Int Braz J Urol 2017;43. https://doi.org10.1590/S1677-5538.IBJU.2017.0016.
de la Torre G, Barusso G, Chernobilsky V, Borghi M, Montes de Oca L, Becher E. Outpatient simultaneous treatment of benign prostatic hyperplasia and bladder lithiasis with GreenLightTM and holmium laser. J Endourol 2012;26:164–167. https://doi.org10.1089/end.2011.0249. DOI: https://doi.org/10.1089/end.2011.0249
Gomez Sancha F, Rivera VC, Georgiev G, Botsevski A, Kotsev J, Herrmann T. Common trend: move to enucleation—Is there a case for GreenLight enucleation? Development and description of the technique. World J Urol 2015;33:539–547. https://doi.org10.1007/s00345-014-1339-9. DOI: https://doi.org/10.1007/s00345-014-1339-9
Hossack T, Woo H. Validation of a patient reported outcome questionnaire for assessing success of endoscopic prostatectomy. Prostate Int 2014;2:182–187. https://doi.org10.12954/PI.14066. DOI: https://doi.org/10.12954/PI.14066
Mamoulakis C, Efthimiou I, Kazoulis S, Christoulakis I, Sofras F. The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol 2011;29:205–210. https://doi.org10.1007/s00345-010-0566-y. DOI: https://doi.org/10.1007/s00345-010-0566-y
De Nunzio C, Lombardo R, Autorino R, et al. Contemporary monopolar and bipolar transurethral resection of the prostate: prospective assessment of complications using the Clavien system. Int Urol Nephrol 2013;45:951–959. https://doi.org10.1007/s11255-013-0476-1. DOI: https://doi.org/10.1007/s11255-013-0476-1
Agha RA, Borrelli MR, Vella-Baldacchino M, et al. The STROCSS statement: Strengthening the Reporting of Cohort Studies in Surgery. Int J Surg 2017;46:198–202. https://doi.org10.1016/j.ijsu.2017.08.586.
Fisher E, Subramonian K, Omar MI. The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men. Cochrane database Syst Rev 2014:CD006744. https://doi.org10.1002/14651858.CD006744.pub3. DOI: https://doi.org/10.1002/14651858.CD006744.pub3
Roehrborn CG, Barkin J, Siami P, et al. Clinical outcomes after combined therapy with dutasteride plus tamsulosin or either monotherapy in men with benign prostatic hyperplasia (BPH) by baseline characteristics: 4-year results from the randomized, double-blind Combination of Avodart and Tamsulo. BJU Int 2011;107:946–954. https://doi.org10.1111/j.1464-410X.2011.10124.x. DOI: https://doi.org/10.1111/j.1464-410X.2011.10124.x
Tufek I, Mourmouris P, Argun OB, et al. Robot-Assisted Bladder Diverticulectomy with Concurrent Management of Bladder Outlet Obstruction. Urol Int 2016;96:432–437. https://doi.org10.1159/000443799. DOI: https://doi.org/10.1159/000443799
Hora M, Eret V, Stránský P, et al. Laparoscopic urinary bladder diverticulectomy combined with photoselective vaporisation of the prostate. Videosurgery Other Miniinvasive Tech 2015;1:62–67. https://doi.org10.5114/wiitm.2015.49671. DOI: https://doi.org/10.5114/wiitm.2015.49671
Brassetti A, DE Nunzio C, Delongchamps NB, Fiori C, Porpiglia F, Tubaro A. Green light vaporization of the prostate: is it an adult technique? Minerva Urol Nefrol 2017;69:109–118. https://doi.org10.23736/S0393-2249.16.02791-0.

How to Cite

Castellucci, R., Marchioni, M., Fasolis, G., Varvello, F., Ditonno, P., Di Rienzo, G., Greco, F., Altieri, V. M., Frattini, A., Ferrari, G., Schips, L., & Cindolo, L. (2020). The safety and feasibility of the simultaneous use of 180-W GreenLight laser for prostate vaporization during concomitant surgery. Archivio Italiano Di Urologia E Andrologia, 92(4). https://doi.org/10.4081/aiua.2020.4.297