Original articleGreenLight 180-W XPS laser versus 120-W HPS laser for the treatment of benign prostate hyperplasia by a single experienced urologist

ObjectiveThis study aims to evaluate the operative efficacy and safety of the GreenLight 180-W XPS laser system in comparison to the GreenLight 120-W HPS system used by a single experienced surgeon for the treatment of bladder outlet obstruction caused by an enlarged prostate.Materials and methodsWe retrospectively compared the patients undergoing GreenLight 180-W XPS (September 2014-September 2015) and GreenLight 120-W HPS (August 2008-September 2009) for lower urinary tract symptoms secondary to benign prostatic hyperplasia by a single experienced surgeon. The patient baseline characteristics, perioperative parameters, and complications were recorded. Prostate size and prostate-specific antigen were also assessed. Functional parameters, including International Prostate Symptom Score, maximum uroflow rate, postvoid residual, and quality of life score, were analyzed in different follow-up periods.ResultsA total of 130 patients (65 in the HPS and 65 in the XPS group) were included in this study. Intraoperative lasing time was significantly shorter in the XPS group, but the postoperative length of catheterization and hospital stay were comparable in both groups. The number of fibers used during vaporization was significantly less, and only one case required two fibers for prostate vaporization in the XPS group (p = 0.03). During the follow-up period, there was statistically significant improvement compared with baseline in all functional parameters in each group. However, no significant difference was observed in these parameters between the two groups. The mean percentages of prostate volume reduction were 57% and 41% and those of prostate-specific antigen reduction were 60% and 49%, respectively, in the XPS and HPS groups. Complications were comparable between the two groups.ConclusionThe 180-W XPS system displays a shorter lasing time, less laser fiber use, more volume reduction, and a comparable safety profile in comparison with the 120-W HPS system for the treatment of bladder outlet obstruction caused by an enlarged prostate.