Prostate Photovaporization for BPH Beneficial Long-Term
Average International Prostate Symptom Score remained low 5 years after the PVP laser procedure.
|The following article is part of conference coverage from the 2017 American Urological Association meeting in Boston. Renal and Urology News' staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2017.|
BOSTON — Photovaporization of the prostate (PVP) provides symptom improvement for 5 years in patients with benign prostatic hyperplasia (BPH), researchers reported at the American Urological Association 2017 annual meeting.
Jehanne Calves, MD, and Georges Fournier, MD, of the University Hospital of Brest in France, evaluated the efficacy of the GreenLight XPS™ laser procedure with transrectal ultrasonography monitoring in providing durable functional improvement in 84 symptomatic BPH-treated patients (mean age 68 years) at their institution from September 2010 to September 2012. Patients' preoperative PSA volume was 73 mL on average; 22% had a prostate volume greater than 100 mL. The power rate applied with the laser was 5.3 kJ/cc.
According to questionnaire responses, patients experienced notable symptom relief. The average International Prostate Symptom Score (IPSS) fell significantly from a moderate 19 before PVP to a mild 8, 6, and 3, at 1, 3, and 12 months after the procedure, respectively. After 48 months, average IPSS held steady at 5. Mean PSA level also declined significantly from 4 ng/mL before PVP to 2 ng/mL at 3 months, then climbed slowly to 2.6 at 48 months.
Urinary measurements also showed the improvement. Maximum urine flow (Qmax) significantly increased from an average 9 mL/sec before PVP to 21 and 23 mL/sec at 1 and 3 months, respectively. Qmax stabilized at 25 mL/sec at 12 months.
Four patients required reoperation, including 2 each for recurrent benign prostatic obstruction and bladder neck contracture.
International Index of Erectile Function (IIEF-5) scores did not change after surgery. None of the patients were found to have prostate cancer.
Overall, 88% of patients reported satisfaction with PVP after an average 57 months of follow-up. “PVP with the GL-XPS is a safe and effective laser technique at improving durably IPSS in patients with symptomatic BPH,” Dr Calves and Dr Fournier concluded.
Calves J and Fournier G. Long-term outcomes after photovaporization of benign prostatic hyperplasia using XPS Greenlight® Laser : A 5-year follow-up study. [abstract] J Urol 2017;197(4S):e10. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12, 2017. Poster MP 02-03.