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Efficacy and safety profile of GreenLight laser photoselective vaporization of the prostate in ≥ 75 years old patients: results from the Italian GreenLight Laser Study Group

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Abstract

Background

Benign Prostatic Obstruction (BPO) is the most common non-malignant urological condition among men and its incidence rise with age. Among prostate treatments, GreenLight laser seems to reduce bleeding and would be safer in the aging population.

Aims

We aimed to compare the functional outcomes and safety profile of < 75 years old (Group A) and ≥ 75 years old (Group B) patients.

Methods

In a multicenter setting, we retrospectively analyzed all the patients treated with GreenLight Laser vaporization of the prostate (PVP).

Results

1077 patients were eligible for this study. 757 belonged to Group A (median age 66 years) and 320 to Group B (median age 78 years). No differences were present between the two groups in terms of prostate volume, operative time, hospital stay, PSA decrease over time after surgery, complications and re-intervention rate with a median follow-up period of 18 months (IQR 12–26). Nevertheless, focusing on complications, GreenLight laser PVP demonstrated an excellent safety profile in terms of hospital stay, re-intervention and complications, with an overall 29.6% complication rate in older patients and only two cases of Clavien III. Functional outcomes were similar at 12 month and became in favor of Group A over time. These data are satisfactory with a Qmax improvement of 111.7% and an IPSS reduction of 69.5% in older patients.

Discussion and conclusions

GreenLight laser photoselective vaporization of the prostate is a safe and efficient procedure for all patients, despite their age, with comparable outcomes and an equal safety profile.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

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Author information

Authors and Affiliations

  1. Urology Unit, Civil Hospital of Guastalla, Azienda USL-IRCCS di Reggio Emilia, Via Donatori di Sangue 1, 42016, Guastalla, RE, Italy

    Davide Campobasso & Antonio Frattini

  2. Department of Urology, University Hospital of Parma, Parma, Italy

    Davide Campobasso

  3. Department of Urology, “Hesperia Hospital”, Centro Urologico Europeo (C.Ur.E), Modena, Italy

    Simone Morselli, Salvatore Rabito, Giovanni Ferrari & Luca Cindolo

  4. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Simone Morselli

  5. Urologic Clinic, Centro Salute Uomo, Bergamo, Italy

    Francesco Greco

  6. Department of Urology, “Sant’Andrea” Hospital, Sapienza University, Rome, Italy

    Cosimo De Nunzio

  7. Department of Urology, Azienda Ospedaliera Città della Salute e della Scienza di Turin–Sede Molinette, Turin, Italy

    Paolo Destefanis & Paolo Gontero

  8. Department of Urology, “S. Lazzaro” Hospital, Alba, Italy

    Giuseppe Fasolis & Francesco Varvello

  9. Department of Urology, Santa Maria delle Croci Hospital”, Ravenna, Italy

    Salvatore Voce & Giulio Reale

  10. Department of Urology, Santa Chiara Regional Hospital, Trento, Italy

    Tommaso Cai

  11. Department of Urology, “Ulivella e Glicini Clinic”, Florence, Italy

    Rino Oriti

  12. Department of Urology, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy

    Agostino Tuccio

  13. Department of Urology, Clinica Urologica Azienda Ospedaliera - University of Padova, Padua, Italy

    Lorenzo Ruggera

  14. Department of Urology, “S. Giovanni Evangelista” Hospital, Tivoli, Italy

    Antonino Laganà

  15. Department of Urology, Santa Croce e Carle” Hospital, Cuneo, Italy

    Claudio Dadone

  16. Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy

    Gaetano De Rienzo

  17. Department of Urology, AORN “Antonio Cardarelli”, Naples, Italy

    Luigi Pucci & Maurizio Carrino

  18. Department of Urology, San Giacomo” Hospital, Novi Ligure, Italy

    Franco Montefiore

  19. UOSD Urologia, Fondazione Policlinico Tor Vergata, Rome, Italy

    Roberto Miano

  20. Department of Medical, Oral and Biotechnological Sciences, “G. D’Annunzio” University of Chieti, Chieti, Italy

    Luigi Schips

  21. Department of Urology, University of Modena and Reggio Emilia, Modena, Italy

    Salvatore Micali

  22. Department of Urology, “Villa Stuart” Private Hospital, Rome, Italy

    Luca Cindolo

Authors
  1. Davide Campobasso
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  2. Simone Morselli
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  3. Francesco Greco
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  4. Cosimo De Nunzio
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  5. Paolo Destefanis
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  6. Giuseppe Fasolis
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  7. Francesco Varvello
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  8. Salvatore Voce
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  9. Giulio Reale
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  13. Lorenzo Ruggera
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  14. Antonino Laganà
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  15. Claudio Dadone
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  18. Luigi Pucci
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  19. Maurizio Carrino
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  21. Salvatore Rabito
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  22. Roberto Miano
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  26. Giovanni Ferrari
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  27. Luca Cindolo
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Contributions

Conceptualization, Methodology, Writing—original draft preparation: DC; Methodology, Writing—original draft preparation, Formal analysis: SM; Material preparation, data collection: FG, PD, GF, FV, SV, GR, TC, RO, AT, LR, AL, CD, PG, GD, LP, MC, FM, SR, RM, LS, AF; Supervision: CD, GF, SM; Conceptualization, Methodology, review and editing: LC.

Corresponding author

Correspondence to Davide Campobasso.

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Conflict of interest

P.D., L.R., C.D., G.F., and L.C. do surgical tutorship for AMS and received honoraria for their tutorship. All other authors have no competing financial interests that exist.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

Ethical approval

Ethical approval was waived by the local Ethics Committee of the University of Chieti in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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

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Campobasso, D., Morselli, S., Greco, F. et al. Efficacy and safety profile of GreenLight laser photoselective vaporization of the prostate in ≥ 75 years old patients: results from the Italian GreenLight Laser Study Group. Aging Clin Exp Res 35, 877–885 (2023). https://doi.org/10.1007/s40520-023-02351-9

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