Clinical Research Office of the Endourological Society Global GreenLight Laser Study: Outcomes from a contemporary series of 713 patients.

Abstract

To evaluate the outcome in patients undergoing photoselective vaporization of the prostate for benign prostatic obstruction as part of the Clinical Research Office of the Endourological Society Global GreenLight Laser Study. Data were collected on 713 patients with lower urinary tract symptoms suggestive of benign prostatic obstruction undergoing photoselective vaporization of the prostate at 25 centers worldwide, between April 2010 and April 2012. Three types of GreenLight laser powers were used: 80W, 120W or 180W. Intraoperative and postoperative complications were recorded. Outcome parameters measured at baseline, 6-12weeks, 6months and 12months were: uroflow measurements, International Prostate Symptom Score; prostate-specific antigen and International Index of Erectile Function. Operating time was shortest with the 180-W laser at 53.8min. Intraoperatively, bleeding occurred in 3.1% of patients. Statistically significant changes were reported in maximum flow rate, postvoid residual urine, International Prostate Symptom Score, quality of life score and prostate-specific antigen (P<0.01) at each time-point assessed for the 80- and 120-W lasers as well as for the 180-W laser, with the exception of prostate-specific antigen at 6months and 12months. There were 14 Clavien-Dindo gradeIII-A complications and two gradeIII-B. The incontinence rate at 12months was 6.3%, 4.5%, and 2.6% for the 80, 120 and 180W lasers, respectively. The overall blood transfusion rate was 0.4%. Objective and subjective improvement after GreenLight laser treatment worldwide was significant at 1-year follow up. Morbidity and complications were low. Although not a randomized control study, the data can provide an indication of the outcome of the different GreenLight laser powers.