Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Transurethral resection of the prostate (TURP) vs GreenLight photoselective vaporization of benign prostatic hyperplasia: analysis of BPH6 outcomes after 1 year of follow-up


The surgical treatment of benign prostatic obstruction is changing over the time, thanks the increase evidence about the successful role of laser techniques in this surgery. We aimed to compare prostatic GreenLight photovaporization (PVP) to bipolar transurethral resection of the prostate (TURP) with regard to lower urinary tract symptoms (LUTS) improvement through the evaluation of BPH6. We enrolled 220 consecutive subjects affected by LUTS. We performed a propensity score matching using prostate volume, peak flow and International Prostate Symptoms Score (IPSS). A total of 110 (55 TURP and 55 PVP) were analyzed. We found after 1 year of follow-up that the rate of subjects resulting in greater BPH6 recovery in the PVP group vs TURP (45.6% vs 18.2%; P=0.001). The TURP treatment showed greater catheterization time (4.67 vs 1.25; P<0.01) while PVP showed greater recovery experience (82.4 vs 58.2; <0.01). Postoperative ejaculatory dysfunctions were observed in both groups, 58.8% in TURP and 34.5% in PVP group. The multivariate logistic regression analysis, adjusted for preoperative variables, showed that PVP was independently associated with BPH6 recovery end point (odds ratio=3.77; P<0.01). This study showed data in favor of PVP. Although IPSS and peak flow improvements were similar, PVP showed better clinical outcomes.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1


  1. 1

    de la Rosette J, Elhilali M, Naito S, Unal D, Razvi H, Liatsikos E et al. Clinical Research Office of the Endourological Society Global GreenLight Laser Study: outcomes from a contemporary series of 713 patients. Int J Urol 2015; 22: 1124–1130.

    Article  Google Scholar 

  2. 2

    Favilla V, Cimino S, Salamone C, Fragala E, Madonia M, Condorelli R et al. Risk factors of sexual dysfunction after transurethral resection of the prostate (TURP): a 12 months follow-up. J Endocrinol Invest 2013; 36: 1094–1098.

    CAS  Article  Google Scholar 

  3. 3

    Russo GI, Castelli T, Urzi D, Privitera S, La Vignera S, Condorelli RA et al. Emerging links between non-neurogenic lower urinary tract symptoms secondary to benign prostatic obstruction, metabolic syndrome and its components: a systematicreview. Int J Urol 2015; 22: 982–990.

    Article  Google Scholar 

  4. 4

    Russo GI, Cimino S, Fragala E, Privitera S, La Vignera S, Condorelli R et al. Relationship between non-alcoholic fatty liver disease and benign prostatic hyperplasia/lower urinary tract symptoms: new insights from an Italian cross-sectional study. World J Urol 2015; 33: 743–751.

    CAS  Article  Google Scholar 

  5. 5

    Vanella L, Russo GI, Cimino S, Fragala E, Favilla V, Li Volti G et al. Correlation between lipid profile and heme oxygenase system in patients with benign prostatic hyperplasia. Urology 2014; 83: 1444 e7–13.

    Article  Google Scholar 

  6. 6

    Rieken M, Bachmann A . Update on Greenlight laser vaporization (PVP) 2014. World J Urol 2015; 33: 531–537.

    Article  Google Scholar 

  7. 7

    Lee R, Gonzalez RR, Te AE . The evolution of photoselective vaporization prostatectomy (PVP): advancing the surgical treatment of benign prostatic hyperplasia. World J Urol 2006; 24: 405–409.

    Article  Google Scholar 

  8. 8

    Thomas JA, Tubaro A, Barber N, d'Ancona F, Muir G, Witzsch U et al. A Multicenter randomized noninferiority trial comparing GreenLight-XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two-yr outcomes of the GOLIATH Study. Eur Urol 2016; 69: 94–102.

    Article  Google Scholar 

  9. 9

    Sonksen J, Barber NJ, Speakman MJ, Berges R, Wetterauer U, Greene D et al. Prospective, randomized, multinational study of prostatic urethral lift versus transurethral resection of the prostate: 12-month results from the BPH6 study. Eur Urol 2015; 68: 643–652.

    Article  Google Scholar 

  10. 10

    Lee JH, Lee SW . Impact of prostate volume on erectile dysfunction and premature ejaculation. Aging Male 2016; 19: 106–110.

    CAS  Article  Google Scholar 

  11. 11

    Patel VR, Sivaraman A, Coelho RF, Chauhan S, Palmer KJ, Orvieto MA et al. Pentafecta: a new concept for reporting outcomes of robot-assisted laparoscopic radical prostatectomy. Eur Urol 2011; 59: 702–707.

    Article  Google Scholar 

  12. 12

    Roehrborn CG, Wilson TH, Black LK . Quantifying the contribution of symptom improvement to satisfaction of men with moderate to severe benign prostatic hyperplasia: 4-year data from the CombAT trial. J Urol 2012; 187: 1732–1738.

    Article  Google Scholar 

  13. 13

    Kluivers KB, Riphagen I, Vierhout ME, Brolmann HA, de Vet HC . Systematic review on recovery specific quality-of-life instruments. Surgery 2008; 143: 206–215.

    Article  Google Scholar 

  14. 14

    Cappelleri JC, Rosen RC . The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience. Int J Impot Res 2005; 17: 307–319.

    CAS  Article  Google Scholar 

  15. 15

    Rosen RC, Catania JA, Althof SE, Pollack LM, O'Leary M, Seftel AD et al. Development and validation of four-item version of Male Sexual Health Questionnaire to assess ejaculatory dysfunction. Urology 2007; 69: 805–809.

    Article  Google Scholar 

  16. 16

    Sandvik H, Seim A, Vanvik A, Hunskaar S . A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighingtests. Neurourol Urodyn 2000; 19: 137–145.

    CAS  Article  Google Scholar 

  17. 17

    Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009; 250: 187–196.

    Article  Google Scholar 

  18. 18

    Bach T, Wolbling F, Gross AJ, Netsch C, Tauber S, Pottek T et al. Prospective assessment of perioperative course in 2648 patients after surgical treatment of benign prostatic obstruction. World J Urol 2017; 35: 285–292.

    Article  Google Scholar 

  19. 19

    Guo S, Muller G, Lehmann K, Talimi S, Bonkat G, Puschel H et al. The 80-W KTP GreenLight laser vaporization of the prostate versus transurethral resection of the prostate (TURP): adjusted analysis of 5-year results of a prospective non-randomized bi-center study. Lasers Med Sci 2015; 30: 1147–1151.

    Article  Google Scholar 

  20. 20

    Cakiroglu B, Sinanoglu O, Dogan AN . Safety of greenlight photoselective vaporisation of prostate in lower urinary tract symptoms due to benign prostatic hyperplasia in patients using anticoagulants due to cardiovascular comorbidities. Arch Ital Urol Androl 2015; 87: 141–143.

    CAS  Article  Google Scholar 

  21. 21

    Pawan V, Anup K, Niraj K, Biswajit N, Punita R, Rajendra A et al. Safety and efficacy of photoselective vaporization of prostate in patients receiving anticoagulants. Minerva Urol Nefrol 2013; 65: 189–195.

    CAS  PubMed  Google Scholar 

  22. 22

    Zhou Y, Xue B, Mohammad NA, Chen D, Sun X, Yang J et al. Greenlight high-performance system (HPS) 120-W laser vaporization versus transurethral resection of the prostate for the treatment of benign prostatic hyperplasia: a meta-analysis of the published results of randomized controlled trials. Lasers Med Sci 2016; 31: 485–495.

    Article  Google Scholar 

  23. 23

    Lukacs B, Loeffler J, Bruyere F, Blanchet P, Gelet A, Coloby P et al. Photoselective vaporization of the prostate with GreenLight 120-W laser compared with monopolar transurethral resection of the prostate: a multicenter randomized controlled trial. Eur Urol 2012; 61: 1165–1173.

    Article  Google Scholar 

  24. 24

    Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; 44: 637–649.

    Article  Google Scholar 

  25. 25

    McVary KT . Erectile dysfunction and lower urinary tract symptoms secondary to BPH. Eur Urol 2005; 47: 838–845.

    Article  Google Scholar 

  26. 26

    Kassabian VS . Sexual function in patients treated for benign prostatic hyperplasia. Lancet 2003; 361: 60–62.

    Article  Google Scholar 

  27. 27

    Li Z, Chen P, Wang J, Mao Q, Xiang H, Wang X et al. The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function: a systematic review and network meta-analysis. Medicine (Baltimore) 2016; 95: e3862.

    Article  Google Scholar 

  28. 28

    Kumar N, Vasudeva P, Kumar A, Singh H . Prospective randomized comparison of monopolar TURP, bipolar TURP and photoselective vaporization of the prostate in patients with benign prostatic obstruction: 36 months outcome. Low Urin Tract Symptoms 2016. doi: 10.1111/luts.12135.

    PubMed  Google Scholar 

Download references


All participants provided written informed consent before enrollment and the study was conducted in accordance with regulatory standards of Good Clinical Practice and the Declaration of Helsinki (1996). The study was approved by our Institutional Research Ethics Committee.

Author information



Corresponding author

Correspondence to G I Russo.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies the paper on International Journal of Impotence Research website

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cimino, S., Voce, S., Palmieri, F. et al. Transurethral resection of the prostate (TURP) vs GreenLight photoselective vaporization of benign prostatic hyperplasia: analysis of BPH6 outcomes after 1 year of follow-up. Int J Impot Res 29, 240–243 (2017).

Download citation

Further reading


Quick links