MRI assessment of tissue effects after 180-W XPS greenlight laser vaporization of the prostate

Background and Objective Photoselective vaporization of the prostate (PVP) is an alternative to transurethral resection of the prostate (TURP) in the surgical management of Benign Prostate Obtruction (BPO), with a better hemostatic effect due to a coagulation depth of several millimeters. The objective of this study was to prospectively assess the tissue effects of PVP by Magnetic Resonance Imaging (MRI). Materials and Methods From December to February 2014, ten patients were included in a prospective study and underwent PVP performed by a single surgeon with the Greenlight™ laser 180-W XPS. A multiparametric MRI of the prostate (Siemens 3T Verio) was achieved the day before the procedure and post-operatively (2 days, 7 days, 3 and 6 months after the procedure). The prostate volume after tissue removal was determined. The depth of necrosis in the prostatic and peri-prostatic tissues were assessed at six different locations. Results The median age and pre-operative prostate volume were 70 years (64–76) and 48.1 ml (19–74.4), respectively. Median prostate volume significantly decreased post-operatively (P < 0.001): At 6 months, median prostate volume reduction was 44.2% (38.7–49.5) (P = 0.001) compared to pre-operative setting. Two and 7 days after the procedure, mean depths of necrosis were 2.5 mm (0–3) and 1.3 mm (0–2.4), respectively. No necrosis was reported 3 and 6 months after the procedure. Conclusions PVP with Greenlight™ XPS 180-W is associated with a significant reduction of prostate volume. The depth of necrosis is low and homogeneous, resulting in a limited risk of peri-operative complications. Lasers Surg. Med. © 2016 Wiley Periodicals, Inc.