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A comparison of incidences of bladder neck contracture of 80- versus 180-W GreenLight laser photoselective vaporization of benign prostatic hyperplasia

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Abstract

Bladder neck contracture (BNC) after GreenLight laser photoselective vaporization (PVP) of benign prostatic hyperplasia is a common complication. In the present study, data of patients received 80 or 180 W PVP were collected. Perioperative parameters, including applied energy, irradiation time, catheter removal time, and hospital stay, were recorded. Postoperative parameters, including maximum urinary flow rate, International Prostate Symptom Score, post-void residual volume, and incidences of BNC, were recorded at 3 and 12 months after operations. Bladder neck tissues were taken at 3 months after operations for immunohistochemical staining and western blot analysis to examine the expressions of collagen I, matrix metalloproteinase-3 (MMP-3), and transforming growth factor-β (TGF-β). Sample size of patients was calculated with a power of 80 %. Chi-square test and one-way analysis of variance were performed as statistical methods. Three hundred twenty-six patients who received potassium titanyl phosphate (KTP) laser and 256 who received X-ray photoelectron spectroscopy (XPS) laser entered into the study. Perioperative parameters were comparable, except for shorter irradiation time in 180 W group (P = 0.032). Postoperative parameters were also similar, except for higher incidence of BNC in 80 W group at 3 months after operations (P = 0.022). Immunohistochemical staining and western blot analysis showed higher expressions of collagen I, MMP-3, and TGF-β in 80 W group than in 180 W group. In conclusion, 80 W GreenLight laser showed a comparable efficacy with 180-W laser in PVP but showed a higher incidence of BNC in short term, which might be the result of up-regulated fibrotic factors in bladder neck triggered by lasers.

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Acknowledgments

We thank Dr. Qinghua Xia, Minimally Invasive Urology Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, China, and Dr. Guiting Lin, Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, USA, for the valuable advices in the design of this study.

Funding

This work was supported by grants from the National Natural Science Foundation of China (No. 81300629) and Natural Science Foundation of Shandong Province (No. ZR2015HQ002).

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    Authors and Affiliations

    1. Minimally Invasive Urology Center, Shandong Provincial Hospital affiliated to Shandong University, 324 Jing5 Wei7 Road, Jinan, 250021, China

      Bo Hu, Zhenyu Song, Yong Zhao, Muwen Wang, Wei Song, Dong Zhang, Xunbo Jin & Haiyang Zhang

    2. Cystoscope Center, Shandong Provincial Hospital affiliated to Shandong University, Jinan, 250021, China

      Hui Liu

    3. Department of Urology, Weifang People’s Hospital, Weifang Medical College, Weifang, 261599, China

      Liang Qiao

    4. Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, 94143, USA

      Haiyang Zhang

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    1. Bo Hu
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    Correspondence to Haiyang Zhang.

    Ethics declarations

    The Ethics Committee of Shandong Provincial Hospital approved the study protocol. A consent was written from each patient before some bladder neck tissues and some residual prostate tissues were taken with biopsy forceps by way of flexible cystoscopy.

    Conflict of interest

    The authors declare that they have no competing interests.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Bo Hu and Zhenyu Song contributed equally to this work.

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    Hu, B., Song, Z., Liu, H. et al. A comparison of incidences of bladder neck contracture of 80- versus 180-W GreenLight laser photoselective vaporization of benign prostatic hyperplasia. Lasers Med Sci 31, 1573–1581 (2016). https://doi.org/10.1007/s10103-016-2017-5

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    • DOI: https://doi.org/10.1007/s10103-016-2017-5

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