GreenLight laser prostatectomy: a safe and effective treatment for bladder outlet obstruction by prostate cancer

OBJECTIVE • To present our experience on photoselective vaporization of the prostate (PVP) in a cohort of men with bladder outlet obstruction (BOO) by prostate cancer. PATIENTS AND METHODS • From 2003 to 2008 we identified 43 patients with prostate cancer treated with PVP. • The patients' hospital records were comprehensively reviewed to obtain preoperative, intra-operative and postoperative data. • Inclusion criteria were patients with BOO or urinary retention with a diagnosis of prostate cancer. RESULTS • Mean operating time was 42 min, mean post-operative hospital stay was 9.6 h. 32 out of 43 patients were discharged home within 24 h. Twelve patients (28%) did not need post-operative catheter. Mean and median catheter times were 22 and 21.5 h respectively. • Complications were mild: 1 patient needed bladder irrigation, 3 failed initial TWOC, 1 had early stress incontinence. Three had clot retention. • At 3 months post-operatively, 41 of 42 evaluable patients were voiding without a catheter. The mean peak flow rate had increased by 80% and a mean residual volume decreased of 49%. • Four patients underwent a second laser treatment. Three had developed further retention between 7 and 23 months post-operatively and did not want further surgery. The local failure rate at a mean follow up of 22 months was 7 of 39 patients (18%). CONCLUSION • The present study is the first on PVP applied to patients with prostate cancer. • It is shown that, for patients with CaP bothered by LUTS or retention, GreenLight laser prostatectomy is very safe and gives excellent relief from symptoms, with a good improvement in peak flow rate.