GreenLight HPS 120-W Laser for Benign Prostatic Hyperplasia: Comparative Complications and Technical Recommendations

The most common surgical procedure for symptomatic benign prostatic hyperplasia is transurethral resection of the prostate. However, this procedure has complications, including bleeding, erectile dysfunction, and retrograde ejaculation. Alternative therapies have been developed with the aim of reducing the level of complications while maintaining efficacy. These include microwave therapy, transurethral needle ablation, and a range of laser procedures. Recently, photoselective vaporization of the prostate (PVP) was introduced using the GreenLight 60-W laser (American Medical Systems, Minnetonka, Minnesota, USA) and later the 80-W laser, which is the predominant device used in PVP trials. The latest evolution is the GreenLight HPS 120-W laser (532 nm), which produces not only rapid vaporization of prostate tissue but also an acceptable rate of complications. Here we present a review of complications associated with surgical therapies for benign prostatic hyperplasia including data on the initial use of the GreenLight HPS 120-W system. Recommendations are provided on how the low complication rates achieved with PVP can be reduced even further through modification of the operating procedure.