Management of Benign Prostatic Hypertrophy by Prostatic Photovaporization Using the XPS 180 W Laser in the Urology Service of the Nord Franche Comte Hospital

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Surgery for benign prostatic hyperplasia (BPH) is very common in general urology departments in France, including the Nord Franche-Comté Hospital (HNFC). Several minimally invasive techniques have been developed in recent years to significantly reduce the morbidity associated with surgery and the length of hospital stays, including prostatic photovapourisation (PVP) using the GreenLight laser. In the absence of HoLEP in our facility, PVP is the only therapeutic alternative for patients at high risk of haemorrhage. This study was conducted to assess the outcomes of this technique in our department. The aim of this study was to analyze the management of symptomatic benign prostatic hyperplasia (BPH) using prostatic photovapourization with the GreenLight laser. Methods: This was a one-year retrospective descriptive monocentric study of 78 patients treated for BPH with GreenLight laser PVP by a single operator with significant experience of more than 200 cases. Functional results (IPSS, quality of life, debimetry), operating time, amount of energy used, length of hospitalisation, catheterisation duration, and complications were analysed. Follow-up was conducted one month post-operatively. Results: The mean weight of the prostate was 55.77 g. Preoperatively, the median IPSS score was 15, the mean quality of life score was 3.69, and the mean Qmax was 10.44 ml/s. The mean residual post-void volume (RPV) was 152.45 ml. The median duration of vaporization was 32.5 minutes, and the median energy used was 223.5 KJ. The surgical procedure was performed on an outpatient basis in 56.41% of cases, and the mean catheterization duration was 1.53 days. Postoperatively, the mean IPSS score was 3.84, the mean quality of life score was 1.28, and the mean Qmax was 25.55 ml/s. A total of 21 postoperative complications were recorded, 18 of which were classified as grade 1 and 3 as grade 2 according to the Clavien-Dindo classification. Conclusion: Prostatic photovapourisation with the GreenLight XPS 180 W laser is a viable alternative to TURP in the management of benign prostatic hyperplasia, with shorter catheterisation times, similar functional outcomes, and lower morbidity. However, it does not allow histological analysis due to the absence of tissue samples.

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