Greenlight laser versus Diode laser vaporization of the prostate: 3-year results of a prospective non-randomized study open site


Date: Oct 7, 2014

Background and Objective Laser vaporization of the prostate is one of the alternatives to transurethral resection of the prostate (TURP). Short-term studies report a comparable outcome after laser vaporization with the 532 nm 120-W Greenlight high performance system (HPS) laser and the 980 nm 200 W high-intensity diode (diode) laser. In this study, we analyzed the intermediate-term results of both techniques. Materials and Methods From January 2007 to January 2008, 112 consecutive patients with symptomatic benign prostate enlargement were non-randomly assigned to treatment with the Greenlight laser or the diode laser. Perioperative parameters, postoperative functional outcome, complications and the reoperation rate at 3 years were analyzed. Results Improvement of voiding symptoms (IPSS, QoL) and micturition parameters (maximum flow rate, postvoid residual volume) showed no significant difference between HPS- and the diode-group. A significantly higher reoperation rate was observed in the diode-group in comparison to the HPS-group (37.5% vs. 8.9%, p=0.0003) due to obstructive necrotic tissue (16.1% vs. 0%, p=0.0018), bladder neck stricture (16.1% vs. 1.8%, p=0.008), and persisting or recurrent adenoma (5.4% vs. 7.1%, p=0.70), respectively. Conclusions Both lasers lead to comparable improvement of voiding parameters and micturition symptoms. Treatment with the 200 W diode laser led to a significantly higher reoperation rate, which might be attributed to a higher degree of coagulation necrosis. Thus, a careful clinical application of this diode laser type is warranted.

Application: Others