Comparison between open simple prostatectomy and green laser enucleation of the prostate for treating large benign prostatic hyperplasia: a single-centre experience
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This study sought to compare perioperative outcomes and morbidities for open simple prostatectomy (OSP) and endoscopic green laser enucleation of the prostate (GreenLEP).
In a single department, all consecutive patients who underwent OSP between January 2005 and December 2010 were retrospectively reviewed, and all consecutive patients undergoing GreenLEP between July 2013 and January 2017 were prospectively enrolled. Perioperative data, information regarding early postoperative complications for up to 6 months and outcomes were collected and retrospectively compared.
Overall, 204 patients were enrolled in each group. The baseline characteristics of patients in both groups were comparable. Intraoperative time was significantly longer for the OSP group than for the GreenLEP group (67 versus 60 min; p < 0.0001). The OSP group had significantly longer catheterisation (5 versus 2 days; p < 0.0001) and hospitalisation times (7 versus 2 days; p < 0.0001) than the GreenLEP group. The overall rate of complications was significantly higher after OSP than after GreenLEP (37.2 versus 20.6%; p = 0.0003); both Clavien–Dindo grade 3a complications (8.8 versus 0.98%) and Clavien–Dindo grade 3b complications (2.4 versus 3.4%) were observed. The transfusion rate was higher after OSP than after GreenLEP (8.3 versus 0.5%; p = 0.0001). The rehospitalisation rate was similar for both groups (7.8 versus 8.3%; p = 0.99).
The results of this single-centre cohort study confirm those of similar prior investigations addressing endoscopic enucleation of the prostate. Compared with OSP, GreenLEP may have a more desirable perioperative profile with lower morbidity. In contrast, GreenLEP and OSP were associated with similar 6-month rehospitalisation rates.
KeywordsGreenLight Laser Prostate Enucleation Benign prostatic obstruction Surgical technique
Protocol/project development: Misrai, Zorn. Data collection or management: Pasquie, Misrai. Data analysis: Pasquie. Manuscript writing/editing: Misrai, Guillotreau, Bordier, Lhez, Elman
Compliance with ethical standards
Conflict of interest
Vincent Misrai is a consultant and proctor for Boston Scientific. Kevin Zorn is a consultant and proctor for Boston Scientific. Benoit Bordier, Benjamin Elman, Jean Michel Lhez and Julien Guillotreau have no disclosures to declare.
Research involving human participants and/or animals
Not applicable for that section.
All patients referred for BPO that required green laser enucleation of the prostate were included in this evaluation after providing informed written consent.
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