[Analysis of predictive factors of success for prostate photovaporization in benign prostatic hyperplasia by greenlight laser]

Abstract

Objective: To conduct a descriptive study of the implementation of greenlight laser photovaporization in a local hospital and to identify the ideal preoperative and intraoperative conditions to obtain a successful outcome.

Material and methods: A retrospective review of 179 photovaporizations performed between January 2007 and June 2010 was done. Preoperative data (age, prostate volume, PSA, IPSS, Qmax, medical history, ASA classification), intraoperative parameters (surgeon's experience, operating time, transfusion requirements, type of laser used, reconversion to transurethral resection of the prostate or TURP) and post-operative data (post-op complications, post-op PSA, post-op IPS score, post-op Qmax and reoperations) were analyzed. We performed a univariate and multivariate analysis to identify which preoperative and intraoperative parameters influence therapeutic failure.

Results: The descriptive study shows similarity in all parameters compared to the available literature. In the multivariate analysis, it was found that the surgeon's experience and prostate volume over 40 cc were independent predictive factors for success of greenlight laser photovaporization.

Conclusions: Greenlight laser photovaporization is an effective and reproducible procedure for treating lower urinary tract obstruction due to benign prostatic hyperplasia (BPH). Multicenter, prospective and randomized studies are needed to confirm the results of this study. There are few studies available in the literature that provide a high level of evidence and grade of recommendation.