Patient satisfaction with laser therapy

Patient satisfaction with laser therapy



The value of laser therapy in BPH

Benign prostatic hyperplasia (BPH) is characterised by the development of lower urinary tract symptoms (LUTS), including voiding and storage problems, and has an increasing incidence in men over the age of 50 years.1,2 TURP is the current standard surgical procedure for men with prostate sizes of 30-80 mL and bothersome moderate-to-severe LUTS secondary of BPO.3 Alternative therapy methods are being considered, including laser therapy.3

Our laser therapy portfolio has the ability to deliver benefits to your patients in three key areas:

1.
Technological advancements

 


2.
Durable efficacy


3.
Patient satisfaction

Compared to TURP, laser therapy has shown shorter hospitalisation and catheterisation times4 with one study reporting median catheterisation times of 22 hours versus 46.7 hours, respectively.5

At Boston Scientific, we continue to improve and develop our laser treatment portfolio. The GreenLight XPSTM Laser Therapy System has advanced technical specifications, with a maximum power of 180W and an improved beam geometry of the MoXyTM fiber.6

Lumenis Pulse 120H Holmium Laser System with MOSESTM Technology provides 15% faster enucleation and 40% quicker hemostasis than a standard holmium laser.7,8 This leads to better vision clarity and control, allowing you to build confidence after only 20 supervised procedures.7–9

Learn more about the benefits of the MOSESTM Technology:

    

There are three types of laser technology you can choose from in the Boston Scientific BPH portfolio – photovaporization of the prostate (PVP) with GreenLight, holmium laser enucleation of the prostate (HoLEP) with Lumenis Pulse 120H Holmium Laser System with MOSES Technology, and Auriga XLTM 50W Holmium Laser.10,11

Both are safe and effective alternatives to TURP.12,13 They have a proven track record of delivering lasting symptom relief with low retreatment rates at 5 and even 10 years.12,14

Explore key outcomes below:

Long-term improvements in symptoms with GreenLight XPSTM 12,15

Symptom relief and quality of life improvements vs baseline were maintained at 5 years.12,15

laser therapy

 

Another study with a five-year follow-up showed similarly significant results.15 This second study also showed 88% of patients were at least “mostly satisfied” with the treatment at the 5-year mark.15

In one study, there were no long-term complications reported12

There were a small number of long-term complications reported in another study:15

• One patient was prescribed anticholinergics

• Bladder neck contracture, urethral stricture, and reintervention for BPO were observed in two patients each

• Urinary incontinence was experienced by three patients

• Five patients were receiving alpha-blockers 

These results from two single center, single surgeon case series were in line with previously-reported outcomes from the GOLIATH RCT.12,15

The Lumenis Pulse™ 120H Holmium Laser System delivers the long-term benefits of HoLEP.14

HoLEP laser provides excellent and durable clinical outcomes (PVR, Qmax, IPSS, and QoL).14

laser therapy clinical data

*Compared to standard holmium.

**At 10-year follow-up.

Safety data suggest HoLEP is comparable to TURP.16

HoLEP demonstrates better outcomes than TURP with regards to hemoglobin loss, bladder irrigation, catheterization time, hospital stay, and blood transfusion.17 Both incontinence and voiding as measured by the ICS-SF compare favorably with TURP data and the global impact of urinary symptoms (BPHII) is similar to that expected following successful BPH treatment.16 The ground-breaking MOSES 2.0 Technology offers an efficient18–22 treatment for a wide range of patients22-24 including a broad range of prostate sizes25,26 and patients treated with anticoagulants.22- 24

88% (74/84) of patients were at least mostly satisfied 57 months after treatment with GreenLight XPS.5 to 15

92% (35/38) of patients were highly satisfied with the HoLEP procedure with a mean follow up of 6 years.16


Learn more about our laser portfolio

Decorative Image

Download the academic publications

 

 

References

1. Barry MJ, Roehrborn CG. Benign Prostatic Hyperplasia. BMJ. 2001;323:1042–1046.
2. Egan KB. The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates. Urol Clin North Am. 2016;43(3):289–297.
3. EAU Guidelines
4. Capitán C, Blázquez C, Martin MD, et al. GreenLight HPS 120-W Laser Vaporization Versus Transurethral Resection of the Prostate for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Randomized Clinical Trial With 2-Year Follow-Up. Eur Urol. 2011;60(4):734–739.
5. Bachmann A, Tubaro A, Barber N, et al. 180-W XPS GreenLight Laser Vaporization Versus Transurethral Resection of the Prostate for the Treatment of Benign Prostatic Obstruction: 6-Month Safety and Efficacy Results of a European Multicentre Randomized Trial -The GOLIATH Study. Eur Urol. 2014;65(5):931–942.
6. Data on File with Boston Scientific.
7. Large T, Nottingham C, Stoughton C, et al. Comparative study of holmium laser enucleation of the prostate with MOSES enabled pulsed laser modulation. Urology. 2020;136:196–201.
8. Nevo A, Faraj KS, Cheney SM, et al. Holmium laser enucleation of the prostate using MOSES 2.0 vs non‐MOSES: a randomised controlled trial. BJU Int. 2021;127(5):553–559.
9. El‐Hakim A, Elhilali MM. Holmium laser enucleation of the prostate can be taught: the first learning experience. BJU Int. 2002;90(9):863–869.
10. GreenLight XPS Directions for Use.
11. Lumenis Pulse Directions for Use.
12. Ajib K, Mansour M, Zanaty M, et al. Photoselective vaporization of the prostate with the 180-W XPS Greenlightlaser: Five-year experience of safety, efficiency and functional outcomes. Can Urol Assoc J. 2018;12(7):E318–E324.
13. Michalak J, Tzou D, Funk J. HoLEP: the gold standard for the surgical management of BPH in the 21(st) Century. Am J Clin Exp Urol. 2015;3(1):36–42.
14. Elmansy HM, Kotb A, Elhilali MM. Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of followup. J Urol. 2011;186(5):1972–1976.
15. Calves J, Thoulouzan M, Perrouin-Verbe MA, et al. Long-Term Patient-Reported Clinical Outcomes and Reoperation Rate After Photovaporization with the XPS-180W GreenLight Laser. Eur Urol Focus. 2019;5(4):676–680.
16.  Gilling PJ, Aho TF, Frampton CM, et al. Holmium Laser Enucleation of the Prostate: Results at 6 Years. Eur Urol. 2008;53(4):744–749
17. Zhong J, Feng Z, Peng Y, et al. A systematic review and meta-analysis of efficacy and safety following holmium laser enucleation of prostate and transurethral resection of prostate for benign prostatic hyperplasia. Urology. 2019;131:14–20.
18. Agarwal DK, Large T, Tong Y, et al. Same day discharge is a successful approach for the majority of patients undergoing holmium laser enucleation of the prostate. Eur Urol Focus. 2021 Jan 4;S2405‐4569(20)30320‐5.
19. Kavoussi NL, Nimmagadda N, Robles J, et al. MOSES technology for holmium laser enucleation of the prostate: A prospective double‐blind randomized control trial. J Urol. 2021; 206(1):104‐8.
20. Large T, Nottingham C, Stoughton C, et al. Comparative study of holmium laser enucleation of the prostate with MOSES enabled pulsed laser modulation. Urology. 2020;136:196‐201.
21. Nottingham CU, Large T, Agarwal DK, et al. Comparison of Newly Optimized Moses Technology vs Standard Holmium: YAG for Endoscopic Laser Enucleation of the Prostate. J Endourol. 2021;35(9):1393‐99
22. Nevo A, Faraj KS, Cheney SM, et al. Holmium laser enucleation of the prostate using MOSES 2.0 vs non‐MOSES: a randomised controlled trial. BJU Int. 2021;127(5):553‐9.
23. Agarwal DK, Large T, Stoughton CL, et al. Real‐World Experience of Holmium Laser Enucleation of the Prostate with Patients on Anticoagulation Therapy. J Endourol. 2021;35(7):1036‐41.
24. Tamalunas A, Westhofen T, Schott M, et al. The clinical value of holmium laser enucleation of the prostate in octogenarians. Low Urin Tract Symptoms. 2021;13(2):279‐285.
25. Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline 2021. J Urol. 2021;206:806‐26.
26. Agarwal DK, Rivera ME, Nottingham CU, et al. Catheter removal on the same day of holmium laser enucleation of the prostate: Outcomes of a pilot study. Urology. 2020;146:225‐9.

 

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