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Catheter-Dependent Patients Undergoing GreenLight Laser Photoselective Vaporisation of the Prostate: A Retrospective Observational Study of Postoperative Catheter-Free Outcomes

Year: 2025

Type: article

Abstract: OBJECTIVE: This study aimed to evaluate first-time trial without catheter (TWOC) outcomes and postoperative urinary retention rates during short-term follow-up at three to six months in men with long-term catheterisation (LTC) or intermittent self-catheterisation (ISC) undergoing GreenLight laser photoselective vaporisation of the prostate (GLL.PVP). METHODS: This retrospective observational study included 20 consecutive men with benign prostatic hyperplasia (BPH) who were dependent on LTC or ISC and underwent GLL.PVP between May 2023 and July 2024 at a tertiary centre in the United Kingdom. During this period, 50 GLL.PVP procedures were performed, and these 20 cases represented all eligible catheter-dependent patients who met the inclusion criteria. Data were collected from clinical health records, including postoperative documentation, lower urinary tract symptoms (LUTS) clinic notes, TWOC clinic assessments, and emergency department presentations with urinary retention. Parameters analysed included patient age, prostate volume, catheter status, high-risk factors, and objective voiding parameters such as post-void residual urine volume (PVR) and maximum urinary flow rate (Qmax). The primary endpoint was first-time TWOC success, and the secondary endpoint was catheter-free status at three to six months. RESULTS: The mean patient age was 72.8 ± 8.6 years, and the mean prostate volume was 72.5 ± 36.3 mL. Prior to surgery, 18 patients (90%) were managed with LTC and two (10%) with ISC. Nine patients (45%) were identified as high-risk due to anticoagulation therapy, prostate volume greater than 100 mL, or recurrent urinary retention. First-time TWOC was successful in 15 patients (75%), while five patients (25%) failed. At three to six months, 16 patients (80%) remained catheter-free, whereas four patients (20%) experienced recurrent urinary retention requiring re-catheterisation. Among patients who achieved catheter-free status postoperatively, the average PVR was 95 mL, and the average maximum urinary flow rate (Qmax) was 12.8 mL/s. CONCLUSION: GLL.PVP appears to be a safe and feasible intervention for catheter-dependent men with BPH, demonstrating encouraging short-term outcomes with a high rate of successful first-time TWOC and sustained catheter-free status. These findings provide preliminary evidence supporting the potential role of GLL.PVP as a minimally invasive option for restoring spontaneous voiding in men with chronic catheter dependence.

Source: Cureus

DOI: 10.7759/cureus.95650

Authors: A B Azharul Islam, Maisha Zaman Poushi

Institutions: Countess of Chester Hospital, Dhaka Medical College and Hospital

Language: English

Topic: Urinary Bladder and Prostate Research

Subfield: Urology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4415656959