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Usage of GreenLight HPS 180-W laser vaporisation for treatment of benign prostatic hyperplasia

Authors: Mirko Jovanović, Zoran Džamić, Miodrag Aćimovć, Boris Kajmaković, Tomislav Pejčić

Pages: 57-61

DOI: 10.2298/ACI1401057J

Introduction Laser therapy has gained increasing acceptance as a relatively less invasive treatment for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). From the early procedure of interstitial laser coagulation through to the use of holmium laser enucleation of the prostate, there has been an expanding body of evidence on the efficacy of such procedures. One of the newer lasers is the Green Light HPS 180 W  laser. Studies with this GreenLight laser (GLL) (American Medical Systems, Inc, Minnetonka, MN, USA)  showing results as good as those of transurethral resection of the prostate (TURP). In this paper, the efficacy of the new GLL 180-W versus the gold standard TURP in patients with LUTS due to BPH was tested in a prospective clinical trial. ObjectiveTo compare results of Green light laser (GLL) evaporisation of the prostatae  and transurethral resection of the prostate (TURP) for treatment of BPH.Materijals and methodsA total of 62 patients with BPH were randomly assigned to two equal groups: TURP or GLL.ResultsBoth groups were compared regarding all relevant preoperative, operative, and postoperative parameters. Functional results in terms of improvement of International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), and postvoid residual (PVR) urine were assessed at 1, 3, 6 and 12 mo. A total of 62  patients completed 12 mo of follow-up in the TURP and GLL groups, respectively.Baseline characteristics were comparable. Mean operative time was significantly shorter for TURP. Compared to preoperative values, there was significant reduction in hemoglobin levels at the end of TURP only. A significant difference in favor of GLL was achieved regarding the duration of catheterization and hospital stay. In the GLL, no major intraoperative complications were recorded and none of the patients required blood transfusion. Among TURP patients, 6  required transfusion, 1 developed TUR syndrome, and capsule perforation was observed in 5 patients. There was dramatic improvement in Qmax, IPSS, and GLL compared with preoperative values and the degree of improvement was comparable in both groups at all time points of follow-up.  Four TURP patients and one GLL patients developed bladder neck contracture  treated by bladder neck incision; none in either group experienced urethral stricture or urinary incontinence.ConclusionsCompared to transurethral resection of the prostate, GreenLight HPS 180-W laser photoselective vaporization of the prostate is safe and effective in the treatment of patients suffering from lower urinary tract symptoms due to benign prostatic hyperplasia.






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WORLD CUP: Controversial send-off rocks BrazilLionel Messi once again proved he was a class above for Argentina against Nigeria.LIVE coverage of the FIFA World Cup 2014 in Brazil. Every day we follow the Socceroos on their World Cup journey. Plus all the highlights from Brazil, the latest breaking World Cup news, the best goals, the results and the real stories behind the scenes of the World Cup.Here are this morning’s results:• Nigeria 2 Argentina 3. Ahmed Musa scored twice for Nigeria, but Lionel Messi grabbed a brace of his own to match Neymar’s record of four goals in three games so far.• Bosnia-Herzegovina 3 Iran 1. Iran could have qualified for the knockout phase with a win, but it never even threatened to beat the Bosnians, who exited the tournament in style.• Honduras 0 Switzerland 3. Xherdan Shaqiri scored a brilliant hat-trick for the Swiss, who sealed their place in the round of 16.• Ecuador 0 France 0. Ecuador’s captain, Antonio Valencia, was sent off controversially, leaving his side hamstrung. The scoreless draw sealed top spot in Group E for France.“Ref, ref, he said Ronaldo is better than me!” Lionel Messi has scored four goals at this World Cup for Argentina.Source:AFPScroll to the bottom of the page to relive our coverage of Ecuador v France and Honduras v Switzerland.cosplay wigsMORE: Every scenario in every group explainedMORE: Check out our World Cup 2014 predictorMORE: Everything you need to know about the World Cup

9:40am — ‘SUAREZ MUST BE BANNED FOR SIX MONTHS’The UK Telegraph’s chief sports writer, Paul Hayward, says Uruguayan striker Luis Suarez should be banned for at least six months.“The man-child who destroyed England’s World Cup hopes has a pathological problem and must pay for it with a minimum six-month ban from football,” Hayward writes.“Suarez is apparently incapable of calculating the cost of inflicting pain on a fellow professional in this way.“After three incidents, it is not football’s business to put an arm round him,” he says. “The game’s duty is to protect the victim.”Uruguay forward Luis Suarez picks some Italian out of his teeth.Source:AFP9:20am — BALOTELLI SLAPS DOWN HIS CRITICSItalian striker Mario Balotelli has hit back angrily against fans who say he’s “not Italian”.lace front wigs“I’m Mario Balotelli, I’m 23, and I didn’t choose to be Italian,” he said.“I really wanted it because I was born in ITALY and I’ve always lived in ITALY. This World Cup meant a lot to me and I’m sad, angry and disappointed with myself.”Balotelli, whose parents were both born in Ghana, was pulled off at half time during Italy’s decisive 1-0 loss to Uruguay earlier this week. He has been targeted by racist Italian supporters before, and told to “get out” of the country.MORE: Balotelli responds to the haters

Mario Balotelli sits alone on Italy’s bench.Source:Getty Images8:55am — WHAT DO THESE RESULTS MEAN?Argentina’s 3-2 win over Nigeria this morning sealed top spot in Group F.That result could have spelled trouble for Nigeria, but Iran allowed the African side to qualify for the round of 16 by losing to Bosnia-Herzegovina in the other early game.France failed to score against Ecuador, but still finished first in Group E. Meanwhile, Xherdan Shaqiri’s brilliant hat-trick led Switzerland to a 3-0 victory over Honduras and pushed the Swiss into second place.So, these fixtures have been confirmed for the round of 16:Argentina v Switzerland, 2am WednesdayFrance v Nigeria, 2am TuesdayFrance, Switzerland, Argentina and Nigeria have advanced.perruques — LAVEZZI DOESN’T HAVE TIME FOR THISThis Vine shows one of Argentina’s gazillion star forwards, Ezequiel Lavezzi, preparing to come on as a substitute against Nigeria this morning.The older man on the right is Argentina’s manager, Alejandro Sabella. He’s trying to give Lavezzi some last minute instructions. Lavezzi doesn’t seem particularly interested. Finally, he sprays Sabella with his water bottle.

Well, that's not disrespectful at all.Sub-type:commentCAPTION:8:00am — HONDURAS 0 SWITZERLAND 3Xherdan Shaqiri’s hat-trick, which included one particularly sumptuous goal from outside the box, has sent Switzerland through to the round of 16.The scoreline looks bad for Honduras, but it did threaten Switzerland’s goal frequently throughout the second half. This could have been much closer.Now the Swiss must contemplate a knockout match against Lionel Messi’s Argentina. Good luck with that.MATCH REPORT: Honduras v SwitzerlandXherdan Shaqiri of Switzerland celebrates scoring his team's first goal against Honduras.perruques cheveux naturelsSource:Getty Images7:55am — ECUADOR 0 FRANCE 0The South American side has done incredibly well to hold France scoreless, considering the controversial send-off of its captain, but that result isn’t enough for Ecuador to reach the round of 16.Needless to say, both teams struggled to finish their chances. French strikers Karim Benzema and Olivier Giroud were particularly bad, firing several would-be matchwinning shots straight at the Ecuadorean goalkeeper.France has qualified for the knockout phase on top of Group E.Segundo Castillo of Ecuador challenges Karim Benzema of France.Source:Getty Images7:45am — HOW’S THIS FOR A STAT?According to New Statesman, a professional footballer is more likely to be bitten by Luis Suarez than by a shark.

If you’re a player, there’s a one-in-2000 chance that Suarez will chow down on you. That’s compared to a one-in-3.7 million chance of getting bitten by a shark.MORE: Suarez’s Jaws momentSub-type:commentCAPTION:Finally found a Luis Suarez image that hasn't been photoshopped.— Jason Kent (@JKent__) June 25, 2014Sub-type:commentCAPTION:pre bonded hairBest one yet? #Suarez— Totally Man Utd™ (@TotallyMUFC) June 25, 20147:30am — HAT-TRICK!Xherdan Shaqiri has scored again for Switzerland, and become the first Swiss player since 1954 to score a World Cup hat-trick.Switzerland has all but qualified now. That stoppage time winner against Ecuador 10 days ago was so important.Xherdan Shaqiri of Switzerland celebrates scoring against Honduras.Source:Getty Images7:20am — WHAT’S WITH THE HAIR NET?Ecuadorean midfielder Christian Noboa copped a nasty blow to the head during a clash with France’s Blaise Matuidi in the first half, and required a bandage.He has our sympathy. But how exactly is this bizarre net on his head supposed to help?I guess it could be holding his bandage in place. But you know what else could do that? Tape. Other athletes generally use tape.Ecuador’s Christian Noboa sports a hair net against France.Source:SBSSub-type:commentCAPTION:Sub-type:commentCAPTION:Christian Noboa sporting the best World Cup hat of all time. #ECU— Football__Tweet (@Football__Tweet) June 25, 20147:05am — ECUADOR’S CAPTAIN SENT OFFOh no. The Ecuadorean captain, Antonio Valencia, has been sent off. That could destroy his teammates’ chances.Valencia put his foot on top of the ball as he slid into a challenge with French defender Digna. His studs slid off the ball and into Digna’s leg. Digna stayed on the ground for a long time, and as soon as his treatment was over, the referee sent Valencia off.That seems very harsh to me.

6:46am — HALF TIME ... ECUADOR NEEDS GOALSWe’ve reached half time in both matches. Switzerland is leading Honduras 2-0, thanks to a brace from Xherdan Shaqiri, and Ecuador has played out a scoreless half with France.If those scores remain the same at full time, Switzerland will progress to the round of 16 at Ecuador’s expense.French defender Mamadou Sakho was lucky to escape a red card for elbowing an Ecuadorean in the face during the first half — the referee didn’t see it. The South Americans might need some more luck when they return from the sheds.France's Mamadou Sakho and Ecuador's Enner Valencia.remy hair extensionsSource:AP6:30am — SHAQIRI SCORES AGAINThe Bayern Munich midfielder has polished off a classy counterattack that started all the way back in Switzerland’s half, giving his side a 2-0 lead.The Ecuador v France game is still scoreless, so as everything stands, the Swiss will make it through.Switzerland's Xherdan Shaqiri celebrates scoring against Honduras.Source:AP6:05am — EARLY GOAL FOR SWITZERLANDThat’s a ripper from Xherdan Shaqiri. He’s curled the ball into the top corner from long range to give Switzerland a 1-0 lead.Remember, if the Swiss better Ecuador’s result against France, they progress to the round of 16. So this is the ideal start.Switzerland's Xherdan Shaqiri (23) celebrates ... with an interesting sense of style.Source:APSwitzerland's Xherdan Shaqiri suspended in midair while scoring the opening goal.Source:AP6.00am — FRANCE v ECUADOR and SWITZERLAND v HONDURASTHE basic scenario is this: Ecuador or Switzerland, whichever team does better in its respective game, should advance out of group E alongside France.Follow our blow-by-blow coverage of both games at the bottom of the page.This Honduras World Cup fan might just be the scariest in Brazil.Source:Getty Images5.00am — NIGERIA 2 ARGENTINA 3A DOUBLE from Lionel Messi Argentina to a 3-2 win over African champion Nigeria and assured it of finishing top of Group F at the World Cup finals this morning.But concerns have been raised over Argentina’s reliance on the superstar.Nigeria’s defeat — their fourth in four meetings at the finals against Argentina — came with the considerable consolation that they still progressed to the second round as Iran lost 3-1 to Bosnia-Herzegovina in the other group game.Sub-type:commentCAPTION:Messi carrying Argentina Neymar carrying Brazil British Airways carrying England— World Cup 2014 (@WorIdCupTweets) June 25, 2014Sub-type:commentCAPTION:Lionel Messi in the World Cup 2014 : 3 Games : 3 times : MAN OF THE MATCH.— Arg — Chile. J❤ (@AddictedToBarca) June 25, 2014Sub-type:commentCAPTION:Neymar- 4 goals in 3 games, 2 MOTM Messi- 4 goals in 3 games, 3 MOTM Ronaldo-about to make it 3 haircuts in 3 games— barcastuff (@barcasstuff) June 25, 20144.30am — BOSNIA-HERZEGOVINA 3 IRAN 1BOSNIA-Herzegovina ended Iran’s World Cup knockout hopes by beating it 3-1 in Salvador today.Goals from Edin Dzeko, Miralem Pjanic and Avdija Vrsajevic restored some pride after a hugely disappointing tournament for the Bosnians, whose elimination had already been confirmed following defeats to Argentina and Nigeria.Iran, for whom Reza Ghoochannejad scored, needed to win the group G game and hope Nigeria lost to Argentina in Porto Alegre, which it did 3-2, to maintain its hopes of reaching the last 16.LIVE UPDATES