A Study of the Role of ۱۸۰W XPS Lithium Triborate Laser in the Treatment of Patients With Lower Urinary Tracts Symptoms Due to Benign Prostatic Hyperplasia

Abstract Introduction: Benign prostatic hyperplasia (BPH) is a disease of the prostate commonly seen in elderly males known to cause lower urinary tract symptoms (LUTS) that may require surgery as a part of treatment. Transurethral resection of the prostate (TURP) is considered the gold standard of surgical treatment, but it is not without complications. Laser photoselective vaporisation of the prostate (PVP), introduced in ۱۹۹۸ as an ۸۰ W Nd:YAG laser which passed through a KTP (potassium-titanyl-phosphate) crystal, emerged as a safe alternative to TURP in selected cases. A recent upgrade to the Greenlight XPS ۱۸۰ W powered with an LBO (lithium triborate) crystal has been available for use since ۲۰۱۲. Data on the use of this new upgrade is still being collected and analysed, especially in patients with large prostates or high risk cases. We analysed cases done at Jaslok Hospital over a ۲-year period.Methods: A total of ۳۴ patients who underwent Laser PVP using XPS ۱۸۰W for LUTS due to BPH at Jaslok Hospital were part of this study. We analysed the pre- and postoperative variables and the intraoperative parameters of all patients.Results: The XPS ۱۸۰W was found to be safe and efficacious. Eighteen patients were high-risk cases, classified as ASA (American Society of Anesthesiologists) Classes ۳ and ۴. Average postoperative catheter duration was ۴۰.۱۸ hours. In prostates of size <۸۰ mL, an average of ۲۲۹ kJ of energy was used. In large prostates (>۸۰ mL), an average of ۳۹۰ kJ of energy was used. No major complications were seen in any of the high-risk patients, classified as Clavien Dindo Class ۳ and ۴. The postoperative drop in IPSS (International Prostate Symptom Score) was ۸.۷.Conclusion: We found that Green Light Laser XPS ۱۸۰W may be used for large (>۸۰ g) prostates, hitherto an indication for open surgery, and that it may be used in high-risk patients, who were otherwise unfit for TURP. It is safe and efficacious. Further, multicenter trials are required to confirm the findings. Keywords: LUTS BPH GreenLight Laser PVP XPS ۱۸۰W Laser Prostatectomy