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Campobasso et al. Mini-invasive Surg 2021;5:45 https://dx.doi.org/10.20517/2574-1225.2021.92 Page 5 of 9

Table 2. Type of complications
Clavien-Dindo No re-intervention Re-intervention Overall P
Complications
grade n= 832 n = 35 n = 867 value
Perioperative
Prostatic capsule perforation IIIa 6 (0.7%) 0 (0.0%) 6 (0.7%) 0.614
Early (< 30 days)
Fever < 38 °C I 15 (1.8%) 1 (2.9%) 16 (1.8%) 0.650
Fever > 38 °C I 23 (2.8%) 1 (2.9%) 24 (2.8%) 0.974
Burning urination I 127 (15.3%) 9 (25.7%) 136 (15.7%) 0.096
Frequency I 66 (7.9%) 2 (5.7%) 68 (7.8%) 0.633
De novo urge I 96 (11.5%) 6 (17.1%) 102 (11.8%) 0.313
Urge incontinence I 54 (6.5%) 4 (11.4%) 58 (6.7%) 0.252
Stress incontinence I 38 (4.6%) 3 (8.6%) 41 (4.7%) 0.274
Hematuria I 24 (2.9%) 1 (2.9%) 25 (2.9%) 0.992
Retention I 71 (8.5%) 5 (14.3%) 76 (8.8%) 0.238
UTI II 10 (1.2%) 1 (2.9%) 11 (1.3%) 0.391
Blood transfusion II 4 (0.5%) 0 (0.0%) 4 (0.5%) 0.681
MACE IVb 6 (0.7%) 1 (2.9%) 7 (0.8%) 0.167
Late complication
Stress incontinence I 26 (3.1%) 1 (2.9%) 27 (3.1%) 0.929
Bladder neck/prostatic fossa contracture IIIb 0 (0%) 22 (62.8%) 22 (2.6%) < 0.001
requiring reintervention
BPH recurrence requiring surgical reintervention IIIb 0 (0%) 13 (37.2%) 13 (1.4%) < 0.001
Patient global impression of improvement 0.003
I 401 (51.5%) 11 (34.4%) 412 (50.9%)
II 291 (37.4%) 11 (34.4%) 302 (37.3%)
III 62 (8.0%) 6 (18.8%) 68 (8.4%)
IV 16 (2.1%) 3 (9.4%) 19 (2.3%)
V 5 (0.6%) 0 (0.0%) 5 (0.6%)
VI 3 (0.4%) 1 (3.1%) 4 (0.5%)

Interestingly, there were no differences in PSA changing and IPSS between the two groups at the follow-up
visit [Table 3]. At the univariate and multivariate logistic regression models only prostate volume ≥ 100 mL
(P = 0.003 and P = 0.010), preoperative urethral stricture (P = 0.013 and P = 0.036), and occurrence of early
complications (P = 0.008 and P = 0.024) were associated with re-intervention [Table 4].

DISCUSSION
Despite the great interest in greenlight treatment for BPO, few data are available on long-term follow up and
even fewer on failure predictors. These aspects depend on the novelty of this technology. The last
development of greenlight was the 180-W XPS launched in 2010. The Goliath Trial, designed at the
beginning of the greenlight 180-W XPS experience in 2011, with 128 patients and 2 years of follow-up,
described non-inferiority compared to TURP, with 9% re-treatment rate vs. 7.6% in the TURP group . In
[15]
this study, the mean prostate volume was 48.6 ± 19.2 mL. However, these data have been overcome by some
retrospective papers. Ajib et al. described a re-intervention rate of 2.6% at 12 months for bladder neck
[16]
contracture and a re-intervention for LUTS relapse of 0.5%, 0.7%, and 4.8% at 12, 24, and 48 months,
respectively. In a previous paper from our database, we reported 24 patients out of 813 (3.1%) requiring re-
intervention with a median follow-up period of 17.7 months (IQR: 12-25.8 months) .
[17]