OBJECTIVE: To evaluate the surgical performance of the new Greenlight XPS-180 W laser system (American Medical Systems, Minnetonka, MI) and the effect of prostate volume (PV), in comparison with the former HPS-120 W system, for the treatment of benign prostatic hyperplasia by photo-selective vaporization of the prostate.
METHODS: Between July 2007 and March 2012, 1809 patients underwent laser photo-selective vaporization of the prostate (1187 patients with the use of HPS-120 W and 622 patients with the use of XPS-180 W) at 7 international centers. All data were collected prospectively. Comparative analysis was performed between XPS and HPS according to PV measured by transrectal ultrasound.
RESULTS: The XPS compared with HPS, allowed significantly reduced laser and operative time (29.6 minutes vs 65.8 minutes and 53 minutes vs 80 minutes, respectively; P < .01 for both). The number of fiber used during the procedures was significantly reduced with the XPS system (1.11 vs 2.28; P < .01), whereas total energy delivered was lower (250.2 kJ vs 267.7 kJ; P = .043). Overall, the mean operative time, mean laser time, and mean energy were all significantly increased according to PV >80 mL vs < 80 mL. However, when stratified according to PV, XPS demonstrates significant advantages compared with HPS, regardless of prostate size in all operative parameters (P < .01).
CONCLUSION: The new XPS-180 W system exhibits significant advantages in all surgical parameters compared with the HPS-120 W system. Overall, with XPS-180 W and HPS-120 W, mean operative time, laser time, and energy usage increased according to PV. This suggests that preoperative evaluation of PV by transrectal ultrasound should be mandatory.
Written by:
Hueber PA, Liberman D, Ben-Zvi T, Woo H, Hai MA, Te AE, Chughtai B, Lee R, Rutman M, Gonzalez RR, Barber N, Al-Hathal N, Al-Qaoud T, Trinh QD, Zorn KC. Are you the author?
Section of Urology, Department of Surgery, Centre Hospitalier de l'Université de Montréal, QC, Canada.
Reference: Urology. 2013 Nov;82(5):1108-13.
doi: 10.1016/j.urology.2013.03.059
PubMed Abstract
PMID: 24242891
