Seth K. Bechis, MD, presented “Point-Counterpoint: HoLEP vs. GreenLightTM PVP – GreenLightTM PVP” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
How to cite: Bechis, Seth K. “Point-Counterpoint: HoLEP vs. GreenLightTM PVP – GreenLightTM PVP.” March 10, 2023. Accessed May 2024. https://grandroundsinurology.com/point-counterpoint-holep-vs-greenlighttm-pvp-greenlighttm-pvp/
Point-Counterpoint: HoLEP vs. GreenLightTM PVP–GreenLightTM PVP – Summary
Seth K. Bechis, MD, compares GreenLightTM photosensitive vaporization of the prostate (PVP) to holmium laser enucleation of the prostate (HoLEP,) illustrating how PVP can safely and effectively treat benign prostatic hyperplasia (BPH) in small and large prostates. Dr. Bechis first establishes BPH prevalence and expenses. He then cites American Urological Association (AUA) guidelines on the surgical management of BPH, noting that PVP may be used on small and average prostates.
Dr. Bechis explains that large prostates are also good candidates for PVP, and PVP can offer an advantage for patients on anticoagulation. Dr. Bechis then emphasizes that 180-watt laser use contributes to properly, safely, and durably treating BPH and creating functional outcomes after two years, regardless of prostate size. He compares data between PVP outcomes on small and large prostates, reviewing differences in operative time, lasering time, and energy per unit volume of the prostate. He evaluates the similar data found between small and large prostates treated with PVP, including hospital stay, quality of life, and International Prostate Symptom Score (IPSS).
Dr. Bechis then explores a 2017 study that found that PVP creates durable results at four years, provided that energy density remains at 3 KJ/cc or higher. Dr. Bechis also stresses that keeping the retreatment rate low for PVP depends on using the correct energy density. He continues by noting that there are fewer complications with PVP compared to HoLEP. Dr. Bechis completes his discussion by examining PVP’s relatively simpler learning curve and proficiency maintenance while also highlighting PVP as a financially sound option in BPH treatment.
This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: HoLEP vs. GreenLightTM PVP – HoLEP.”
About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
