Greenlight Photoselective Vaporisation of the Prostate in 133 High Surgical Risk Patients: A 5-Year Outcome Study

• 作者: Antonio Gómez Rodríguez Antonio Sampietro Crespo Emilio Rubio Hidalgo Fernando álvarez Férnandez Ignacio Gómez García Larissa Lara Luis álvarez Buitrago Marta Romero Molina Natanael García Betancourt Pablo Gutierrez
• 来源期刊: 泌尿学期刊(英文)
• 学科: 医学
• 关键词: Greenlight VAPORISATION PVP HIGH Risk ASA
• 年，卷（期）: 2013,（2）
• 页码范围: 90-95
• 页数: 6页
• 分类号: R73

摘要

Greenlight photoselective vaporisation of the prostate (GPVP) is progressively becoming an established treatment in patients with LUTS because it is a minimally invasive technique that achieves efficient haemostasis, making it the ideal technique for patients at high surgical risk. Material and Methods: To study of 133 patients with an ASA surgical risk score of 3 or 4, undergoing GPVP, with an analysis of perioperative outcome, IPSS, Qmax, IIEF-5 and complications during a five-year follow-up. Results: At 5 years the mean annual improvement in IPSS was stable, and at 5 years there was a 15.2 point improvement versus the preoperative score (p 0.05). The Qmax showed an improvement of 14.9 ml/sec and was maintained at five years after surgery (p 0.05). No patients were transfused or suffered urinary incontinence. 2.25% suffered major complications and there were no deaths. 3.1% of patients suffered de novo urgency. In the 5-year follow-up, five patients had to be reoperated. The quality of sexual health assessed by IIEF-5 before the procedure was scored at 14 points;the 5-year follow-up covering the preoperative period and all revisions did not show any worsening in the IIEF-5 score (p > 0.05). Conclusions: Due to its physical characteristics, in our opinion GPVP is now the treatment of choice in patients at high surgical risk. In our series, the risk of major/minor complications and transfusions was much lower than the same risks in conventional techniques. The objective results (Qmax and quality of life questionnaire) are equivalent to conventional techniques and persist over a 5-year follow-up.