ORIGINAL ARTICLE   Free access

Minerva Urologica e Nefrologica 2017 June;69(3):285-92

DOI: 10.23736/S0393-2249.16.02721-1

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Comparison of GreenLight laser and transurethral resection of the prostate baseline characteristics and outcomes: lessons learned from the Clinical Research Office of the Endourological Society GreenLight Laser Study

Gordon MUIR ¹, Jiri KLECKA ², Daniel J., CULKIN ³, Gabriel H. BARUSSO ⁴, Jan KUMS ⁵, Claus BRUNKEN ⁶, Gregg EURE ⁷, Carlos RIOJA SANZ ⁸, Fernando GOMEZ SANCHA ⁹, Muharrem M. YILDIZ ¹⁰, Jean J., de la ROSETTE ¹¹ ✉

¹ Department of Urology, King’s College Hospital, London, UK; ² Department of Urology, Faculty and Teaching Hospital, Kralovske Vinohrady, Prague, Czech Republic; ³ Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, OK, USA; ⁴ Department of Urology, Center of Urology, Buenos Aires, Argentina; ⁵ Department of Urology, Isala Clinic, Zwolle, The Netherlands; ⁶ Department of Urology, Asklepios Klinik St. Georg, Hamburg, Germany; ⁷ Department of Urology, Urology of Virginia, Eastern Virginia Medical School, Virginia Beach, VA, USA; ⁸ Department of Urology, Hospital General Royo Villanova, Zaragoza, Spain; ⁹ Department of Urology, Advanced Urologic Surgery Institute, Madrid, Spain; ¹⁰ Department of Urology, Private Lokman Hekim Hospitals, Etlik, Ankara, Turkey; ¹¹ Department of Urology, AMC University Hospital, Amsterdam, The Netherlands

BACKGROUND: To compare baseline characteristics and outcomes of patients undergoing GreenLight laser vaporization (GL) or transurethral resection of the prostate (TURP) in a real life setting.
METHODS: In this prospective observational cohort, the Clinical Research Office of the Endourological Society (CROES) collected data of consecutive GL or TURP treated patients. Treatment involved one of three GL laser powers (80 W, 120 W or 180 W) based on availability in each participating centre, or TURP. Data on baseline characteristics as well as functional measures were collected at three time points: 6-12 weeks, 6, and 12months after surgery. Functional measures included urinary flow parameters, perceived prostate function (IPSS), perceived erectile function (IIEF-5) and complications.
RESULTS: Seven hundred thirteen patients underwent GL, and 234 patients underwent TURP. Overall, patients treated with GL show higher BMI, IIEF and medication use, together with lower urinary function (voided volume, incontinence, urinary retention) at baseline. After the procedure, despite higher antibiotic and antimuscarinic use and shorter hospital stay, readmission rates, PVR, PSA were higher, but Qmax, and IIEF were lower in the GL group. The rate of post-operative complications was 10.3% and 5.2% for the TURP and GL group, respectively (P=0.006).
CONCLUSIONS: We were unable to categorically state which procedure is superior. This observational study confirms that treatment decision for either TURP or GL is not based on patient characteristics.

KEY WORDS: Lasers - Prostate - Transurethral resection of prostate