TITLE:
Greenlight Photoselective Vaporisation of the Prostate in 133 High Surgical Risk Patients: A 5-Year Outcome Study
AUTHORS:
Ignacio Gómez García, Marta Romero Molina, Emilio Rubio Hidalgo, Luis Álvarez Buitrago, Natanael García Betancourt, Larissa Lara, Pablo Gutierrez, Antonio Sampietro Crespo, Fernando Álvarez Férnandez, Antonio Gómez Rodríguez
KEYWORDS:
Greenlight; Vaporisation; PVP; High Risk; ASA
JOURNAL NAME:
Open Journal of Urology,
Vol.3 No.2,
May
17,
2013
ABSTRACT: Greenlight photoselective
vaporisation of the prostate (GPVP) is progressively becoming an established
treatment in patients with LUTS because it is a minimally invasive technique
that achieves efficient haemostasis, making it the ideal technique for patients
at high surgical risk. Material and
Methods: To study of 133 patients with an ASA surgical risk score of 3 or
4, undergoing GPVP, with an analysis of perioperative outcome, IPSS, Qmax,
IIEF-5 and complications during a five-year follow-up. Results: At 5 years the mean annual improvement in IPSS was stable,
and at 5 years there was a 15.2 point improvement versus the preoperative score
(p 0.05). The Qmax showed an improvement of 14.9 ml/sec and was
maintained at five years after surgery (p 0.05). No patients were transfused or suffered
urinary incontinence. 2.25% suffered major complications and there were no
deaths. 3.1% of patients suffered de novo urgency. In the 5-year follow-up,
five patients had to be reoperated. The quality of sexual health assessed by
IIEF-5 before the procedure was scored at 14 points; the 5-year follow-up
covering the preoperative period and all revisions did not show any worsening
in the IIEF-5 score (p > 0.05). Conclusions: Due to
its physical characteristics, in our opinion GPVP is now the treatment of
choice in patients at high surgical risk. In our series, the risk of
major/minor complications and transfusions was much lower than the same risks in
conventional techniques. The objective results (Qmax and quality of life
questionnaire) are equivalent to conventional techniques and persist over a
5-year follow-up.