Introduction: Laser therapy has gained increasing acceptance as a relatively
less invasive treatment for lower urinary tract symptoms (LUTS) due to benign
prostatic hyperplasia (BPH). From the early procedure of interstitial laser
coagulation through to the use of holmium laser enucleation of the prostate,
there has been an expanding body of evidence on the efficacy of such
procedures. One of the newer lasers is the Green Light HPS 180 W laser.
Studies with this GreenLight laser (GLL) (American Medical Systems, Inc,
Minnetonka, MN, USA) showing results as good as those of transurethral
resection of the prostate (TURP). In this paper, the efficacy of the new GLL
180-W versus the gold standard TURP in patients with LUTS due to BPH was
tested in a prospective clinical trial. Objective: To compare results of
Green light laser (GLL) evaporisation of the prostatae and transurethral
resection of the prostate (TURP) for treatment of BPH. Materijals and
methods: A total of 62 patients with BPH were randomly assigned to two equal
groups: TURP or GLL.ResultsBoth groups were compared regarding all relevant
preoperative, operative, and postoperative parameters. Functional results in
terms of improvement of International Prostate Symptom Score (IPSS),
maximum flow rate (Qmax), and postvoid residual (PVR) urine were assessed at
1, 3, 6 and 12 mo. A total of 62 patients completed 12 mo of follow-up in the
TURP and GLL groups, respectively. Baseline characteristics were comparable.
Mean operative time was significantly shorter for TURP. Compared to
preoperative values, there was significant reduction in hemoglobin levels at
the end of TURP only. A significant difference in favor of GLL was achieved
regarding the duration of catheterization and hospital stay. In the GLL, no
major intraoperative complications were recorded and none of the patients
required blood transfusion. Among TURP patients, 6 required transfusion, 1
developed TUR syndrome, and capsule perforation was observed in 5 patients.
There was dramatic improvement in Qmax, IPSS, and GLL compared with
preoperative values and the degree of improvement was comparable in both
groups at all time points of follow-up. Four TURP patients and one GLL
patients developed bladder neck contracture treated by bladder neck incision;
none in either group experienced urethral stricture or urinary incontinence.
Conclusions: Compared to transurethral resection of the prostate, GreenLight
HPS 180-W laser photoselective vaporization of the prostate is safe and
effective in the treatment of patients suffering from lower urinary tract
symptoms due to benign prostatic hyperplasia.