The Continuous Evolution of the Greenlight Laser; the XPS Generator and the MoXy Laser Fiber, Expanding the Indications for Photoselective Vaporization of the Prostate

Objective: To report our early experience with new GreenLight XPS generator using the new MoXy laser fiber, examining its efficacy and safety and also its ability to effectively treat the larger prostate gland. Patients and Methods: From July 2010 until August 2012, 131 patients, with an average age of 72.6 years (range 49-92), were treated using the XPS/MoXy system in a single UK center on a day-case basis. Data were prospectively collected. Evaluation of outcome was assessed at 3 months postoperatively comparing both subjective (international prostate symptom score [IPSS]) and objective (Q-max, postvoiding residual [PVR] and prostate volume) parameters to the preoperative data and classified into three groups according to the preoperative prostate size (<40cc, 40-80cc, and >80cc). Results: More than one quarter of patients had a prostate volume >80cc. Overall significant improvement in IPSS (mean reduction by 9.9) and Q-max (mean increase 10.26mL/sec) are observed and were similar across the three groups. Average volume reduction was (51.2%, 49.8%, & 48.1%) for the three groups, respectively. No significant intraoperative or early postoperative complications were reported. Conclusion: Early data confirm that in treating men with symptomatic benign prostate disease, the Greenlight XPS generator and MoXy laser fiber are able to achieve challenging results in terms of clinical outcome and prostate volume reduction irrespective of baseline prostate volume.