Long-term Patient-reported Clinical Outcomes and Reoperation Rate after Photovaporization with the XPS-180W GreenLight Laser
| Autor: | Marie-Aimée Perrouin-Verbe, J. Calves, Antoine Valeri, Vincent Joulin, Georges Fournier, Maxime Thoulouzan |
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| Přispěvatelé: | CHRU de Brest, service de chirurgie urologique et de la transplantation reinale (CHU - BREST - Urologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest) |
| Rok vydání: | 2017 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Longitudinal study Time Factors Urology [SDV]Life Sciences [q-bio] 030232 urology & nephrology Prostatic Hyperplasia Single Center 03 medical and health sciences 0302 clinical medicine Prostate medicine Humans In patient Longitudinal Studies Patient Reported Outcome Measures Prospective Studies Aged Aged 80 and over medicine.diagnostic_test business.industry Middle Aged Prostatic enlargement 6. Clean water Single surgeon 3. Good health Surgery medicine.anatomical_structure Greenlight laser 030220 oncology & carcinogenesis Transrectal ultrasonography Laser Therapy business |
| Zdroj: | European Urology Focus European Urology Focus, Elsevier, 2019, 5, pp.676-680. ⟨10.1016/j.euf.2017.10.006⟩ |
| ISSN: | 2405-4569 |
| DOI: | 10.1016/j.euf.2017.10.006⟩ |
| Popis: | Objective To evaluate the long-term reported clinical outcomes after photovaporization of the prostate (PVP) with the XPS-GreenLight laser in patients with symptomatic benign prostatic enlargement (BPE). Design, setting, and participants A prospective longitudinal study was performed for all consecutive patients with BPE who underwent PVP at our institution between 2010 and 2012. Patient-reported clinical outcomes were assessed at 1 mo, 3 mo, 12 mo, and 57 mo using International Prostate Symptoms Score, International Continence Society, and International Index of Erectile Function short-form questionnaires. Maximum flow rate (Qmax), postvoid residual urine measurements were assessed at 3 mo and 12 mo. Long-term satisfaction, complications, and reoperation rates were assessed by questionnaires. Prostate-specific antigen was measured at 3 mo, 12 mo, and 57 mo. Intervention A single surgeon (GF) has practiced photovaporization with a Moxy fiber, under transrectal ultrasonography monitoring. Long-term clinical outcomes were evaluated using questionnaires. Outcome measurements and statistical analysis The primary measurement was the reoperation. Results and limitations Eighty-four patients of 102 answered the long-term questionnaire. The mean age was 68±7.2 yr. The mean follow-up was 57.4±6.8 mo. The mean prostate volume was 73±38ml. After treatment, the mean International Prostate Symptoms Score decreased significantly from 19.9±6.4 to 6.1±5.6, 3.9±3.4, and 5.9±5.8, respectively, at 3 mo, 12 mo, and 57 mo. The mean prostate-specific antigen level decreased significantly (−56%) from 4.5±4.3ng/ml preoperatively to 2.0±2.0ng/ml and 2.6±2.2ng/ml, respectively, at 12 mo and 57 mo. The mean Qmax increased from 9.6±3.8ml/s preoperatively to 23.9±11.5ml/s and 25.2±9.2ml/s, respectively, at 3 mo and 12 mo. Overall reoperation rate was 4.8%(4/84). Limitations include the single surgeon single center design study and the lack of long-term objectives data such as urodynamic parameters (postvoid residual urine and Qmax). Conclusions Photovaporization of the prostate with the XPS-GreenLight laser is an effective technique able to durably improve reported clinical outcomes in patients with BPE. Patient summary In this study we looked at the long-term outcomes after laser therapy with XPS-GreenLight laser for benign prostatic enlargement. We found a few reoperation rates and good stable reported clinical outcomes after a mean follow-up of 57 mo. We conclude that this laser technique can offer durably good reported clinical outcomes. |
| Databáze: | OpenAIRE |
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