GreenLight laser surgery is at least as effective as the TURP, concludes NICE in new guidance

Greenlight Laser Surgery

We welcome the new NICE guidance which recognises GreenLight laser surgery is at least as effective as the older TURP operation and carries fewer risks and complications.
The latest guidance from the National Institute for Health and Care Excellence (NICE) is based on detailed analysis of studies of patient outcomes from both types of surgery for men with enlarged prostates.

The report published on June 14, 2016, begins: “The case for adopting GreenLightXPS for treating benign prostatic hyperplasia is supported in non-high-risk patients. GreenLightXPS is at least as effective in these patients as transurethral resection of the prostate (TURP).” The NICE report also notes the lower rates of complications from laser treatment compared with the TURP.

GreenLight laser surgery was first introduced in the UK in 2005 as a significantly less invasive alternative to the TURP.

Both procedures are designed to reduce the surplus prostate tissue which obstructs the flow of urine through the urethra.

During the TURP, heated surgical wire is used to cut away the surplus tissue. The alternative option is using laser surgery which vaporises the excess tissue and minimises bleeding. It is called GreenLight because the wavelength used is visible to the eye as green.

NICE considered a wide range of different studies from across the world comparing the two types of surgery.

Their report states: “The committee concluded from the evidence that GreenLightXPS and TURP are equally effective in treating BPH in non-high-risk patients. The committee also noted evidence of fewer complications and readmissions with GreenLight XPS when compared with TURP.”

Birmingham Prostate Clinic was the first in the West Midlands region to introduce GreenLight laser surgery in 2007. We have since carried out more than 600 GreenLight laser procedures and use the most advanced, third generation laser system, the GreenLight XPS.

BPC urologist Alan Doherty, who has carried out one of the highest volumes of these procedures in the UK, said: “We really welcome this guidance, which takes into account the outcomes for many hundreds of patients evaluated in medical studies.

“I am pleased that the guidance notes that the laser used has been upgraded three times to increase power. We used the third generation XPS model which is a 180watt system, compared with the first 80watt console. We have always maintained that using sufficient power is key to achieving good, long term outcomes.

“The take home message from this very significant new NICE guidance is this: TURP should no longer be considered the ‘gold standard’ surgical treatment for BPH.

“Even now, I am aware that some patients are still told laser surgery isn’t as effective as the TURP. Since 2007 we have been very clear: GreenLight laser gives patients equally good results and avoids the higher risk of heavy bleeding, complications and long recovery associated with the TURP.

“It is not necessary for patients to endure the increased risks and longer use of a catheter associated with TURP when we have an equally effective alternative in GreenLight laser, which is so much better tolerated.

“I would advise any man with BPH to read this new guidance from NICE. The availability of GreenLight laser across the UK is patchy (even though this guidance states it would be more cost-effective for the NHS). We see patients from all over the UK and the Republic of Ireland who are clear that they want to avoid the TURP and have GreenLight laser.

“We would also advise people to ask about their surgeon’s experience in GreenLight laser, as we know outcomes are closely related to experience.”

The full report from NICE can be viewed here

GreenLight laser webcast: Michael Priest