Abstract

You have accessJournal of UrologyCME1 May 2022MP01-18 GREENLIGHT PHOTOVAPORIZATION OF THE PROSTATE IN HIGH-MEDICAL-RISK PATIENTS: AN ANALYSIS OF THE GLOBAL GREENLIGHT GROUP (GGG) DATABASE David-Dan Nguyen, Claudia Deyirmendjian, Kyle Law, Naeem Bhojani, Dean Elterman, Bilal Chughtai, Franck Bruyere, Luca Cindolo, Giovanni Ferrari, Carlos Vasquez-Lastra, Tiago Borelli-Bovo, Edgardo Becher, Hannes Cash, Maximillian Reimann, Enrique Rijo, Vincent Misrai, and Kevin Zorn David-Dan NguyenDavid-Dan Nguyen More articles by this author , Claudia DeyirmendjianClaudia Deyirmendjian More articles by this author , Kyle LawKyle Law More articles by this author , Naeem BhojaniNaeem Bhojani More articles by this author , Dean EltermanDean Elterman More articles by this author , Bilal ChughtaiBilal Chughtai More articles by this author , Franck BruyereFranck Bruyere More articles by this author , Luca CindoloLuca Cindolo More articles by this author , Giovanni FerrariGiovanni Ferrari More articles by this author , Carlos Vasquez-LastraCarlos Vasquez-Lastra More articles by this author , Tiago Borelli-BovoTiago Borelli-Bovo More articles by this author , Edgardo BecherEdgardo Becher More articles by this author , Hannes CashHannes Cash More articles by this author , Maximillian ReimannMaximillian Reimann More articles by this author , Enrique RijoEnrique Rijo More articles by this author , Vincent MisraiVincent Misrai More articles by this author , and Kevin ZornKevin Zorn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002513.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous analyses of the safety and effectiveness of GreenLight photoselective vaporization of the prostate (PVP) in high-medical-risk (HMR) patients were limited by their small sample size and the ability to adjust for important confounders. We sought to characterize the adjusted outcomes of GreenLight PVP in HMR patients using data from the largest international database. METHODS: Data were obtained from the Global GreenLight Group (GGG) database which pools data of eight high-volume, experienced surgeons, from a total of seven international centers. All men with established benign prostatic hyperplasia who underwent GreenLight PVP using the XPS-180 W system between 2011 and 2019 were eligible for the study. HMR patients were defined as patients with ASA III or greater and were compared to non-HMR patients. Analyses were adjusted for patient age and prostate volume. RESULTS: In the HMR group, patients on average were older and had smaller prostates than the non-HMR control group. Pre-operatively, HMR patients had greater PVR and worse QoL. Compared to non-HMR patients, transfusions occurred more frequently (2.6% vs. 0.14%, p<0.01) and the odds of readmission were elevated [OR 2.0, (95% CI 1.4–2.8, p<0.01)] among HMR patients. Twelve months postoperatively, HMR patients experience greater improvement in QoL than the control group [+0.54 (95% CI 0.07–1.0, p=0.02)]. PVR also decreased 93.1ml more in HMR than in non-HMR patients after 12 months (95% CI 33.6–152.6, p<0.01). PSA and Qmax change did not differ significantly between both study arms. CONCLUSIONS: We found that GreenLight PVP is safe and effective in improving functional outcomes in higher-risk patients with severe systemic disease. Though absolute risks remain low, GreenLight PVP is associated with higher odds of transfusion and readmission in the high-risk cohort. The findings of our study reaffirm current guidelines that propose PVP as a viable treatment option for HMR patients. Source of Funding: No funding or other financial support was received © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e8 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information David-Dan Nguyen More articles by this author Claudia Deyirmendjian More articles by this author Kyle Law More articles by this author Naeem Bhojani More articles by this author Dean Elterman More articles by this author Bilal Chughtai More articles by this author Franck Bruyere More articles by this author Luca Cindolo More articles by this author Giovanni Ferrari More articles by this author Carlos Vasquez-Lastra More articles by this author Tiago Borelli-Bovo More articles by this author Edgardo Becher More articles by this author Hannes Cash More articles by this author Maximillian Reimann More articles by this author Enrique Rijo More articles by this author Vincent Misrai More articles by this author Kevin Zorn More articles by this author Expand All Advertisement PDF DownloadLoading ...

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