Same-Day Discharge After GreenLight Laser Photoselective Vaporization of the Prostate in Patients With Moderate to...

The most common cause of severe lower urinary tract symptoms (LUTS) in men over 50 is benign prostatic hyperplasia (BPH). A wide range of day-case surgical options are practiced, among which GreenLight Photoselective Vaporization of the Prostate (GL-PVP) is one. This has completely taken over conventional bipolar transurethral resection of the prostate (TURP). There is a need to study whether in patients with moderate and severe International Prostate Symptom Score (IPSS) scores, GL-PVP can give safe and effective outcomes as a same-day discharge (SDD).  Objective: To study the safety and effectiveness of GL-PVP as SDD in patients with moderate and severe LUTS.  Method: The study was conducted at King's College Hospital, United Kingdom (UK). Patients presenting with severe LUTS on IPSS and quality of life (QOL) scoring were included. All patients had their pre-operative IPSS + QOL scoring and flow rate measured by uroflowmetry in the clinic. They underwent GL-PVP and were discharged on the same day safely. Following this post-op, IPSS and flow rate on uroflowmetry were measured in the first follow-up.  Results: A total of 103 patients were included in the study, with prostate size ranging from 30 cc to 124 cc. The average laser time during GL-PVP was 21 mins, with an average energy used of 131,154 J. The mean improvement in IPSS + QOL score was from 25 ± 4 to 11.89 ± 1.61. The mean improvement in Q-max was from 9.81 ml/sec to 15.11 ml/sec. The mean improvement in post-void residual (PVR) volume was from 266 ml to 74.19 ml. None of the patients required secondary admissions or second procedures.  Conclusion: There was a marked improvement in IPSS + QOL scoring along with flow rate and PVR after SDD from GL-PVP prostate, proving efficacy and safety. This can be the alternative surgical option for patients with severe LUTS.