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The 80-W KTP GreenLight laser vaporization of the prostate versus transurethral resection of the prostate (TURP): adjusted analysis of 5-year results of a prospective non-randomized bi-center study

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Abstract

This study aims to compare long-term results of photoselective vaporization of the prostate (PVP) with an 80-W potassium titanyl phosphate (KTP) laser and monopolar transurethral resection of the prostate (TURP) in terms of efficacy, durability, and safety in an adjusted patient population. This prospective, non-randomized bi-center study included 120 (PVP) and 68 (TURP) patients in each arm. Patients were evaluated at 60 months of follow-up. Data from 30 (PVP) and 31 (TURP) patients were available for analysis. The primary outcome measurement was the International Prostate Symptom Score (IPSS) at 5 years. Secondary outcome measurements included voiding symptoms (quality of life (QoL) score), micturition parameters (maximal flow rate, Q max), post-void residual (PVR) volume, prostate-specific antigen (PSA) value, and reoperation rate. At study inclusion, voiding symptoms and micturition parameters were comparable between both groups. Age, prostate volume, and the proportion of patients with platelet aggregation inhibition or oral anticoagulation were significantly higher in the PVP group. No significant difference could be detected between patients available at 60 months and those lost to follow-up in terms of preoperative characteristics in either group. Sixty months postoperatively, the improvement of IPSS, QoL, Q max, and PVR volume showed no significant difference between both groups. PSA reduction was significantly higher after TURP. The reoperation rate due to urethral stricture (PVP, 13 %; TURP, none), bladder neck contracture (PVP, 3 %; TURP, none), and persisting or recurrent adenoma (PVP, 18 %; TURP, 3 %) was significantly higher after the 80-W PVP. Eighty-watt PVP leads to comparable functional outcomes to TURP. However, during a long-term follow-up, significantly more reoperations are necessary after PVP with the 80-W KTP laser, suggesting inferior tissue ablation capacity of the 80-W KTP laser.

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Conflict of interest

Alexander Bachmann is a consultant for American Medical Systems (AMS) and a principal investigator of a study comparing photoselective vaporization of the prostate with the GreenLight XPS™ laser system and transurethral resection of the prostate for the treatment of benign prostatic hyperplasia (The Goliath Study). Heike Püschel is a study nurse and partly paid by AMS. The remaining authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, University Hospital Basel, Basel, Spitalstrasse 21, 4031, Basel, Switzerland

    Sanwei Guo, Georg Müller, Gernot Bonkat, Heike Püschel, Thomas Gasser, Alexander Bachmann & Malte Rieken

  2. Department of Urology, Hospital Baden, Im Ergel 1, 5404, Baden, Switzerland

    Kurt Lehmann & Scherwin Talimi

  3. Department of Urology, Shanghai First People’s Hospital affiliated to Shanghai Jiaotong University, Haining Road 100, 200085, Shanghai, China

    Sanwei Guo

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  1. Sanwei Guo
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  2. Georg Müller
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  3. Kurt Lehmann
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  4. Scherwin Talimi
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  5. Gernot Bonkat
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  6. Heike Püschel
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  7. Thomas Gasser
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  8. Alexander Bachmann
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  9. Malte Rieken
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Correspondence to Malte Rieken.

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Guo, S., Müller, G., Lehmann, K. et al. The 80-W KTP GreenLight laser vaporization of the prostate versus transurethral resection of the prostate (TURP): adjusted analysis of 5-year results of a prospective non-randomized bi-center study. Lasers Med Sci 30, 1147–1151 (2015). https://doi.org/10.1007/s10103-015-1721-x

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  • DOI: https://doi.org/10.1007/s10103-015-1721-x

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