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GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: a randomized clinical trial with 2-year follow-up.
Eur Urol. 2011 Oct; 60(4):734-9.EU

Abstract

BACKGROUND

High-level evidence to support the use of photoselective vaporization of the prostate (PVP) is limited.

OBJECTIVE

Assess the efficacy and safety of GreenLight HPS 120-W laser PVP compared with transurethral resection of the prostate (TURP).

DESIGN, SETTING, AND PARTICIPANTS

A randomized clinical trial was performed with 50 patients having lower urinary tract symptoms due to benign prostatic hyperplasia in each treatment arm.

INTERVENTION

Random allocation to PVP or TURP.

MEASUREMENTS

International Prostate Symptom Score (IPSS), quality of life (QoL), and changes in maximum flow rate (Qmax) were the main end points. Patients were evaluated at a follow-up time of 2 yr. Five patients were lost to follow-up. A last observation carried forward analysis was done.

RESULTS AND LIMITATIONS

Both laser PVP and TURP resulted in the same IPPS reduction at 2 yr (-15.7 and -14.9, respectively; p=0.48) and in the same gain in Qmax (+14.5 ml/s and +13.1 ml/s, respectively; p=0.65). QoL was equivalent for both treatment modalities. These results were independent of prostate size, American Society of Anesthesiologists risk category, and prior indwelling catheter. No statistically significant differences were detected between arms in terms of complication rates. In the laser PVP group, three patients were readmitted to the hospital and two developed a urethral stricture. In the TURP group, two patients were readmitted, six developed a urethral stricture, and two developed bladder neck sclerosis. In-hospital stay and time to catheter removal were significantly shorter with PVP. Limitations are the potential lack of power to detect differences in the complications between groups and the lack of blindness due to the nature of the intervention.

CONCLUSIONS

GreenLight HPS 120-W laser PVP is as effective as TURP for symptom reduction and improvement of QoL. No differences were seen in the response of storage and voiding symptoms. Laser PVP and TURP have the same complication rate. Length of stay is shorter for laser PVP group.

Authors+Show Affiliations

Department of Urology, Hospital Universitario Fundacion Alcorcon, Universidad Rey Juan Carlos, Madrid, Spain. ccapitan@fhalcorcon.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21658839

Citation

Capitán, Carlos, et al. "GreenLight HPS 120-W Laser Vaporization Versus Transurethral Resection of the Prostate for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: a Randomized Clinical Trial With 2-year Follow-up." European Urology, vol. 60, no. 4, 2011, pp. 734-9.
Capitán C, Blázquez C, Martin MD, et al. GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: a randomized clinical trial with 2-year follow-up. Eur Urol. 2011;60(4):734-9.
Capitán, C., Blázquez, C., Martin, M. D., Hernández, V., de la Peña, E., & Llorente, C. (2011). GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: a randomized clinical trial with 2-year follow-up. European Urology, 60(4), 734-9. https://doi.org/10.1016/j.eururo.2011.05.043
Capitán C, et al. GreenLight HPS 120-W Laser Vaporization Versus Transurethral Resection of the Prostate for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: a Randomized Clinical Trial With 2-year Follow-up. Eur Urol. 2011;60(4):734-9. PubMed PMID: 21658839.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: a randomized clinical trial with 2-year follow-up. AU - Capitán,Carlos, AU - Blázquez,Cristina, AU - Martin,M Dolores, AU - Hernández,Virginia, AU - de la Peña,Enrique, AU - Llorente,Carlos, Y1 - 2011/06/01/ PY - 2011/03/07/received PY - 2011/05/23/accepted PY - 2011/6/11/entrez PY - 2011/6/11/pubmed PY - 2012/1/11/medline SP - 734 EP - 9 JF - European urology JO - Eur Urol VL - 60 IS - 4 N2 - BACKGROUND: High-level evidence to support the use of photoselective vaporization of the prostate (PVP) is limited. OBJECTIVE: Assess the efficacy and safety of GreenLight HPS 120-W laser PVP compared with transurethral resection of the prostate (TURP). DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial was performed with 50 patients having lower urinary tract symptoms due to benign prostatic hyperplasia in each treatment arm. INTERVENTION: Random allocation to PVP or TURP. MEASUREMENTS: International Prostate Symptom Score (IPSS), quality of life (QoL), and changes in maximum flow rate (Qmax) were the main end points. Patients were evaluated at a follow-up time of 2 yr. Five patients were lost to follow-up. A last observation carried forward analysis was done. RESULTS AND LIMITATIONS: Both laser PVP and TURP resulted in the same IPPS reduction at 2 yr (-15.7 and -14.9, respectively; p=0.48) and in the same gain in Qmax (+14.5 ml/s and +13.1 ml/s, respectively; p=0.65). QoL was equivalent for both treatment modalities. These results were independent of prostate size, American Society of Anesthesiologists risk category, and prior indwelling catheter. No statistically significant differences were detected between arms in terms of complication rates. In the laser PVP group, three patients were readmitted to the hospital and two developed a urethral stricture. In the TURP group, two patients were readmitted, six developed a urethral stricture, and two developed bladder neck sclerosis. In-hospital stay and time to catheter removal were significantly shorter with PVP. Limitations are the potential lack of power to detect differences in the complications between groups and the lack of blindness due to the nature of the intervention. CONCLUSIONS: GreenLight HPS 120-W laser PVP is as effective as TURP for symptom reduction and improvement of QoL. No differences were seen in the response of storage and voiding symptoms. Laser PVP and TURP have the same complication rate. Length of stay is shorter for laser PVP group. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/21658839/GreenLight_HPS_120_W_laser_vaporization_versus_transurethral_resection_of_the_prostate_for_the_treatment_of_lower_urinary_tract_symptoms_due_to_benign_prostatic_hyperplasia:_a_randomized_clinical_trial_with_2_year_follow_up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(11)00548-3 DB - PRIME DP - Unbound Medicine ER -