Archivio Italiano di Urologia e Andrologia (Feb 2023)

Safety profile of treatment with greenlight versus Thulium Laser for benign prostatic hyperplasia

  • Davide Campobasso,
  • Antonio Barbieri,
  • Tommaso Bocchialini,
  • Gian Luigi Pozzoli,
  • Francesco Dinale,
  • Francesco Facchini,
  • Marco Serafino Grande,
  • Jean Emmanuel Kwe,
  • Michelangelo Larosa,
  • Giulio Guarino,
  • Davide Mezzogori,
  • Elisa Simonetti,
  • Francesco Ziglioli,
  • Antonio Frattini,
  • Umberto Vittorio Maestroni

DOI
https://doi.org/10.4081/aiua.2023.11101

Abstract

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Objective: The major strengths of surgical treatment of benign prostatic hyperplasia with laser are reduced morbidity compared to endoscopic resec-tion. No studies analysed the different risk of intra/peri-opera-tive events between patients undergoing Thulium and GreenLight procedures. Materials and methods: We retrospectively reviewed 100 con-secutive cases undergoing GreenLight vaporization and Thulium procedures performed during the learning curve of two expert endoscopic surgeons. Pre-operative data, intra and post-opera-tive events at 90 days were analysed. Results: Patients on antiplatelet/anticoagulant therapy were pre-dominant in the Green group (p < 0.0001). Rates of blood trans-fusion (p < 0.0038), use of resectoscope (p < 0.0086), and tran-sient stress urinary incontinence were statistically higher in the Thulium group. On the contrary conversions to TURP (p < 0.023) were more frequent in GreenLight patients. Readmissions were more frequently necessary in GreenLight group (24%) vs. Thulium group (26.6%). The overall complica-tion rate in GreenLight and Thulium groups were 31% and 53%respectively; Clavien 3b complications were 13% in Thulium patients versus 1% in GreenLight patients. Conclusions: GreenLight and Thulium treatments show similar safety profiles. Randomized controlled trial are needed to better clarify the rate of major complications in Thulium group, and the incidence of post-operative storage symptoms in these patients’ populations.

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