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Photoselective vaporisation prostatectomy using a GreenLight High Performance System for patients with bleeding
1Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|December 11, 2012
Summary
Photoselective vaporization prostatectomy using the GreenLight High Performance System is a safe treatment for benign prostatic disease in men on anticoagulants. This modified technique shows good outcomes and minimal complications in patients with bleeding tendencies.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Geriatric Medicine
Background:
- Benign prostatic disease (BPD) is common in aging men.
- Patients with BPD often have comorbidities, including those requiring anticoagulant or antiplatelet therapy.
- Managing BPD in patients on anticoagulants presents a bleeding risk with traditional surgical methods.
Purpose of the Study:
- To evaluate the safety and efficacy of a modified vaporisation incision technique using the GreenLight High Performance System.
- To assess outcomes in patients with benign prostatic disease who are on anticoagulant or antiplatelet therapy.
- To determine perioperative and postoperative complications associated with this procedure.
Main Methods:
- A case series of 48 male patients with benign prostatic disease and bleeding tendencies or on anticoagulants.
- Patients underwent photoselective vaporization prostatectomy with a GreenLight High Performance System.
- Prospective data collection on uroflowmetry, serum PSA, prostate volume, and complications over 12 months.
Main Results:
- 81% of patients were discharged without a catheter; mean hospital stay was 3 days.
- Mean peak flow rate improved from 8.7 mL/s to 14.7 mL/s; mean residual volume decreased from 199 mL to 50 mL at 1 year.
- Only one patient required a blood transfusion; five were readmitted for secondary hemorrhage.
Conclusions:
- Photoselective vaporization prostatectomy with the GreenLight High Performance System is a safe and effective treatment option for benign prostatic disease in patients on anticoagulants.
- The modified technique demonstrates favorable functional outcomes and a low complication rate.
- This approach is suitable for an aging population with comorbidities requiring antithrombotic therapy.
