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Optimising patient outcomes with photoselective vaporization of the prostate (PVP): a review
摘要： Benign prostatic hyperplasia (BPH) is a common pathology causing lower urinary tract symptoms (LUTS) and may significantly impact quality of life. While transurethral resection of the prostate (TURP) remains the gold standard treatment, there are many evolving technologies that are gaining popularity. Photoselective vaporization of the prostate (PVP) is one such therapy which has been shown to be non-inferior to TURP. We aimed to review the literature and discuss factors to optimise patient outcomes in the setting of PVP for BPH. A comprehensive search of the electronic databases, including MEDLINE, Embase, Web of Science and The Cochrane Library was performed on articles published after the year 2000. After exclusion, a total of 38 papers were included for review. The evolution of higher powered device has enabled men with larger prostates and those on oral anticoagulation to undergo safely and successfully PVP. Despite continued oral anticoagulation in patients undergoing PVP, the risk of bleeding may be minimised with 5-Alpha Reductase Inhibitor (5-ARI) therapy however further studies are required. Pre-treatment with 5-ARI’s does not hinder the procedure however more studies are required to demonstrate a reliable benefit. Current data suggests that success and complication rate is largely influenced by the experience of the operator. Post-operative erectile dysfunction is reported in patients with previously normal function following PVP, however those with a degree of erectile dysfunction pre-operatively may see improvement with alleviation of LUTS.
关键词： sexual function,outcomes,urinary function,Benign prostatic hyperplasia (BPH),prostate,photoselective vaporization of the prostate (PVP)
更新于2025-09-19 17:15:36
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Application of 180W XPS GreenLight laser vaporization of the prostate for treatment of benign prostatic hyperplasia
摘要： Purpose: To evaluate safety, ef?cacy and clinical outcomes after photovaporization of the prostate with the 180W-XPS Greenlight laser in patients with low urinary tracts symptom secondary to benign prostatic hyperplasia (BPH). Materials and Methods: All 102 patients with lower urinary tract symptoms who underwent 180W XPS laser vaporization of the prostate from April 2017 to April 2018 were enrolled. The preoperative parameters, postoperative functional, uro?owmetry outcomes and complications were collected. Results: All patients were successfully treated with 180W XPS laser vaporization. Mean preoperative prostate volume was 81 ± 28.7 ml and mean laser time was 28.2 ± 12.5 minutes. No major complications intraoperatively or postoperatively were observed and no blood transfusions were required. Comparing to preoperative characteristics, International Prostate Symptom Score (IPSS), maximum ?ow rate (Qmax) and post-void residual (PVR) parameters were improved signi?cantly and sustained during the follow-up period. At 3, 6 and 12-month follow-ups, mean urinary peak ?ow increased from 6.2 ± 2.1 ml per second to 19.8 ± 4.6, 19.4 ± 4.7 and 19.6 ± 4.9 ml per second, respectively. Mean International Prostate Symptom Scores decreased over time, from 28.9 ± 4.5 to 8.2 ± 1.6, 6.2 ± 1.22 and 5.88 ± 1.15 at 3, 6, 12 months, respectively. Conclusions: 180W XPS Greenlight laser vaporization is a safe and effective treatment option for patients with lower urinary tract symptoms secondary to BPH.
关键词： mini-invasive treatment of BPH,Benign prostatic hyperplasia (BPH),180W XPS Greenlight laser
更新于2025-09-12 10:27:22