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Safety and efficacy of GreenLight PVP in octogenarians: evaluation of the Global GreenLight Group database

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Abstract

Introduction

The present study analyzes the largest international GreenLight database, the Global GreenLight Group (GGG), to evaluate the functional and safety profile of GreenLight photoselective vaporization of the prostate (PVP) in octogenarians.

Methods

The GGG is a database comprised of patients that underwent GreenLight PVP from 2011 to 2019 performed by 8 experienced urologists at 7 international hospitals. Patients 80 years or older at the time of surgery were categorized as octogenarians. They were compared to a similar group of PVP patients below the age of 80.

Results

Among 3,648 patients, 586 men were above the age of 80. Compared to patients under the age of 80, octogenarians had larger prostates (76.0 vs 71.9 ml, p = 0.02) and a lower BMI (25.6 vs 26.7, p = 0.045). Operative time was not significantly longer in octogenarians. The improvement in functional outcomes between 80-year-old patients and control patients was not significantly different at one-year follow-up, with the exception of maximum urinary flow (Qmax) that favoured younger patients (10.3 vs 12.6 ml/s, p = 0.02). The odds of transfusion were greater for older patients [OR 8.2 (95% CI 3.6–18.9, p < 0.01)], but they were not at increased risk of hematuria. Octogenarians had higher readmission rates (23.0 vs 11.9%, p < 0.01).

Conclusions

GreenLight PVP is a safe option in well-selected octogenarians in a cohort of patients treated by surgeons experienced with the technology. The odds of transfusion were higher in patients over 80, but the absolute risk remains low. The 30-day hospital readmission rate was higher in octogenarians.

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Data availability

The datasets generated during and/or analyzed during the current study are readily available from the corresponding author upon request.

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Funding

No funding or financial support was received for this study.

Author information

Author notes

  1. Claudia Deyirmendjian and David-Dan Nguyen have contributed equally to this work.

Authors and Affiliations

  1. Faculty of Medicine, Université de Montréal, Montreal, QC, Canada

    Claudia Deyirmendjian

  2. Division of Urology, University of Toronto, Toronto, ON, Canada

    David-Dan Nguyen

  3. Division of Urology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada

    Kyle W. Law, Ahmed Ibrahim, Naeem Bhojani & Kevin C. Zorn

  4. Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Anna-Lisa V. Nguyen

  5. Division of Urology, McGill University, Montreal, QC, Canada

    Iman Sadri & Adel Arezki

  6. Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada

    David Bouhadana

  7. Division of Urology, University Health Network, Toronto, ON, Canada

    Dean S. Elterman

  8. Department of Urology, Weill Cornell Medical College, New York, NY, USA

    Bilal Chughtai

  9. Department of Oncology and Urology, Centre Hospitalier Universitaire de Tours, Centre-Val de Loire, France

    Franck Bruyère

  10. Department of Urology, Hesperia Hospital, “Cure Group”, Modena, Italy

    Luca Cindolo & Giovanni Ferrari

  11. Department of Urology, ABC Medical Center, Mexico City, Mexico

    Carlos Vasquez-Lastra

  12. Borelli Urologia, Ribeirão Presto, Sao Paulo, Brazil

    Tiago Borelli-Bovo

  13. Centro de Urologia, CDU, Buenos Aires, Argentina

    Edgardo F. Becher

  14. Prouro, Urology Berlin, Berlin, Germany

    Hannes Cash

  15. Department of Urology, University of Magdeburg, Magdeburg, Germany

    Hannes Cash

  16. Department of Urology, Charité – Universitaetsmedizin Berlin, Berlin, Germany

    Maximillian Reimann

  17. Department of Urology, Hospital Quiron Barcelona, Barcelona, Spain

    Enrique Rijo

  18. Department of Urology, Clinique Pasteur, Toulouse, France

    Vincent Misrai

Authors
  1. Claudia Deyirmendjian
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  2. David-Dan Nguyen
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  3. Kyle W. Law
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  4. Anna-Lisa V. Nguyen
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  5. Iman Sadri
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  6. Adel Arezki
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  7. David Bouhadana
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  8. Ahmed Ibrahim
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  10. Dean S. Elterman
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  11. Bilal Chughtai
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  12. Franck Bruyère
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  14. Giovanni Ferrari
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  16. Tiago Borelli-Bovo
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  17. Edgardo F. Becher
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  18. Hannes Cash
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  19. Maximillian Reimann
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  20. Enrique Rijo
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  21. Vincent Misrai
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  22. Kevin C. Zorn
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Contributions

CD: project development, data collection, manuscript writing and editing. DDN: project development, data collection, data analysis, manuscript writing and editing. KWL: project development, data collection, manuscript writing and editing. ALVN: project development, data collection, manuscript writing and editing. IS: project development, data collection, manuscript writing and editing. AA: project development, data collection, manuscript writing and editing. DB: project development, data collection, manuscript writing and editing. AI: project development, data collection, manuscript writing and editing. NB: project development, data collection, manuscript writing and editing. DSE: project development, data collection, manuscript writing and editing. BC: project development, data collection, manuscript writing and editing. FB: project development, data collection, manuscript writing and editing. LC: project development, data collection, manuscript writing and editing. GF: project development, data collection, manuscript writing and editing. CV-L: project development, data collection, manuscript writing and editing. TB-B: project development, data collection, manuscript writing and editing. EFB: project development, data collection, manuscript writing and editing. HC: project development, data collection, manuscript writing and editing. MR: project development, data collection, manuscript writing and editing. ER: project development, data collection, manuscript writing and editing. VM: project development, data collection, manuscript writing and editing. KCZ: project development, data collection, manuscript writing and editing.

Ethics declarations

Conflict of interest

Consultants and proctors for Boston Scientific for GreenLight: KZ, DSE, VM, ER, HC, BC. Surgical tutors for GreenLight Xcelerated Performance System and received honoraria for their tutorship: GF, LC. Investigators and consultants for PROCEPT BioRobotics: VM, TB, NB, KZ. All other authors do not have any relevant conflicts of interest.

Ethical approval

All the procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standard.

Informed consent

Formal consent is not required for this type of study (retrospective).

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Deyirmendjian, C., Nguyen, DD., Law, K.W. et al. Safety and efficacy of GreenLight PVP in octogenarians: evaluation of the Global GreenLight Group database. World J Urol 41, 1133–1140 (2023). https://doi.org/10.1007/s00345-023-04334-x

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