The Safety and Feasibility of the Simultaneous Use of 180-W GreenLight Laser for Prostate Vaporization During Concomitant Surgery

This paper focuses on an apparently obvious aspect of clinical practice: the association of photo-selective vaporization of the prostate (PVP) to other surgical procedures. However, if we look at the literature there is little data about transurethral resection of the prostate (TURP) and bipolar TURP (B-TURP) associated with other procedures, endoscopic as well as non-endoscopic, urologic as well as non-urologic. Evidence-based medicine needs reports and objective feedback about even consolidated opinions in clinical routine but not yet supported by trials. In this database extrapolated from a national multicentric database created and updated by high-volume GreenLight surgeons, when PVP is associated with other surgeries, no increase in morbidity or hospital stay are observed.

In the case of hernioplasty, this endoscopic procedure does not seem to increase the risk of infection of the wound or the plug. In hydrocelectomy no increase of urinary or seminal infection is observed. Concomitant endoscopic treatments suggest that the hemostatic efficiency of GreenLight permits further procedures under clean vision.

The higher incidence of urinary retention reported at catheter removal may suggest that associated procedures may be responsible for the reduced efficiency of straining maneuvers at micturition, keeping in mind that patients undergoing multiple procedures were more often catheterized.

This study is a retrospective analysis that limits the generalization of the conclusions, but it gives a picture of common surgical practice and the safety of PVP associated with other surgical procedures making surgeons confident with the use of GreenLight in the most disparate clinical conditions.

Wirtten by: Pasquale Ditonno, MD, Gaetano De Rienzo, Division of Urology, University of Bari, Italy

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