A novel vaporization-enucleation technique for benign prostate hyperplasia using 120-W HPS GreenLightâ„¢ laser: Seoul technique II in comparison with vaporization and previously reported modified vaporization-resection technique

Yoo, Sangjun; Park, Juhyun; Cho, Sung; Cho, Min; Jeong, Hyeon; Son, Hwancheol
December 2017
World Journal of Urology;Dec2017, Vol. 35 Issue 12, p1923
Academic Journal
Purpose: We developed a novel vaporization-enucleation technique (Seoul II), which consists of vaporization-enucleation of the prostate using 120-W HPS GreenLight laser, and enucleated prostate resection using bipolar devices for tissue removal. We compared the outcomes of the Seoul II with vaporization and a previously reported modified vaporization-resection technique (Seoul I). Methods: Among patients with benign prostate hyperplasia who underwent transurethral surgery using GreenLight laser at our institute, 347 patients with prostate volume ≥ 40 ml were included. The impact of surgical techniques on efficacy and postoperative functional outcomes was compared. Results: No difference was found in baseline characteristics, although the prostate volume was marginally greater in Seoul II ( p = 0.051). Prostate volume reduction per operation time ( p < 0.001) and lasing time ( p = 0.016) were greater in Seoul II. At postoperative 12 months, the International Prostate Symptom Score (I-PSS) was lower ( p = 0.011), and the decrement in I-PSS was greater in Seoul II ( p = 0.001) than other techniques. In multivariate analysis, postoperative 12-month I-PSS for Seoul II was significantly superior to vaporization ( p < 0.001), although it was similar to Seoul I. The maintenance of immediate postoperative I-PSS decrement, until postoperative 12 months was superior in Seoul II compared with vaporization ( p = 0.014) and Seoul I ( p = 0.048). Conclusions: Seoul II showed improved efficacy and voiding functional maintenance over postoperative 12 months in patients with prostate volume ≥ 40 ml compared with vaporization and Seoul I. This technique could be easily accepted by clinicians who are familiar with GreenLight lasers and add flexibility to surgery without additional equipment.


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