120W GreenLight High Performance System Laser for Benign Prostate Hyperplasia: 68 Patients With 3-Year Follow-up and Analysis of Predictors of Response

Abstract

To investigate 3-year postoperative results of photoselective vaporization of the prostate using the 120W GreenLight High Performance System photoselective vaporization of the prostate (HPS-PVP) for treating benign prostate hyperplasia (BPH) >30 mL. Records of 68 of 85 men who underwent HPS-PVP and were followed up for 3 years were analyzed retrospectively. Patients were older than 50 years with prostate volume >30 mL, International Prostate Symptom Score (IPSS) ≥8, maximum flow rate (Q(max.)) <15 mL/s, and bladder outlet obstruction (BOO) index ≥20. Parameters, including IPSS and Q(max.), were measured at baseline and 6, 12, 24, and 36 months postoperatively. Patients who improved by at least 30% from baseline IPSS scores were considered responders, and logistic regression analysis was done to determine predictors of response. Mean age, prostate volume, IPSS, Q(max.), and operative time were 71.6 ± 7.3 years, 50.0 ± 17.0 mL, 21.7 ± 7.9, 8.7 ± 3.1 mL/s, and 60.6 ± 31.9 minutes, respectively. Six months postoperatively, 50 (73.5%) patients responded with respect to IPSS score, and 40 (58.8%) maintained improvements at 3 years postoperatively. Analysis at 3-year follow-up showed that for IPSS ≥19, the higher the IPSS the greater the functional bladder capacity (FBC) and the lower the frequency of nocturia; and for BOO index ≥40, the higher the BOO index the better the response. HPS-PVP is a safe and effective procedure for treating BPH, having demonstrated that 60% of patients maintained efficacy at 3 years postoperatively. Baseline IPSS, FBC, nocturia, BOO index, and bladder contractility index were valuable for predicting response to surgery.