Objective: The aim of this study was to examine the influence of a median lobe (ML) on complications and functional results after 4 years of GreenLight photoselective vaporization of the prostate (PVP).
Methods: All men undergoing GreenLight PVP for benign prostatic hyperplasia were included in the baseline analysis and followed prospectively. Two groups were formed according to the presence or absence of the prostatic ML. Complications classified according Clavien and Dindo and functional results (International Prostate Symptom Score [IPSS], quality of life, maximum urinary flow rate [Qmax], and postvoid residual [PVR]) were evaluated with 4 years of follow-up. The pre- and postoperative data were compared by a chi-square test (χ2 ) for the qualitative variables and by a Student t test for the quantitative variables.
Results: A total of 432 patients (172 with ML and 260 without ML) were included prospectively from September 2005 to October 2013. The initial populations were comparable. At 4 years of follow-up, the improvement in mean IPSS was significantly greater for patients with ML at 6, 12, 24, and 48 months. The improvement in Qmax was significantly greater for patients with ML at 1, 6, 24, and 48 months. There was no significant difference between the two groups concerning the PVR reduction, the occurrence of complications, the level of average prostate-specific antigen, and the average ultrasound volume at 4 years.
Conclusion: There is a clearer and longer-lasting improvement in urinary symptoms in patients with prostatic ML. The indication of PVP in those patients seems to be excellent, with good results persisting at 4 years.
Keywords: GreenLight laser; benign prostatic hyperplasia; intravesical prostatic protrusion; laser vaporization; median lobe.
© 2021 John Wiley & Sons Australia, Ltd.