GreenLight laser prostatectomy: Are outcomes sustainable after a decade of surgery? A single-center experience with up to 15 years of followup.

Abstract

Introduction: We aimed to report our single-center experience with long-term outcomes of GreenLight laser prostatectomy over a period of 15 years.

Methods: Between 2005 and 2020, a prospectively maintained database for patients undergoing GreenLight photoselective vaporization of the prostate (PVP) for symptomatic benign prostatic hyperplasia (BPH) was reviewed. Three generations of GreenLight laser were used over this period. Patients with ≥10 years of followup were included. Demographic and perioperative data were collected, including International Prostate Symptom Score (IPSS), quality of life (QoL), peak flow rate (Qmax), postvoid residual urine (PVR), and prostate-specific anitgen (PSA) changes. Perioperative and late adverse events were also recorded.

Results: A total of 712 patients with a mean age of 73.9±7.8 years were included in the present study, with a median followup of 12.1 years and a mean preoperative prostate size of 72.4±15.3 mL. There were significant reductions in mean IPSS, QoL, and PVR (60.4%, 65%, and 72.6%, respectively; all p<0.001) at the most recent followup compared to baseline values. Likewise, a significant improvement in Qmax (8.2 to 17.7 ml/sec, p<0.001) and a PSA reduction of 64.2% were noted at most recent followup. The blood transfusion rate was 1.5%. Transient postoperative dysuria was encountered in 44 (6.2%) patients. Development of bladder neck contracture and urethral stricture were encountered in 18 (2.5%) and 15 (2.1%) patients, respectively. Twenty-four (3.37%) patients required repeat surgery for adenoma regrowth.

Conclusions: Our long-term functional outcomes support the durability of the GreenLight laser PVP with acceptable long-term adverse events after a decade of surgery.