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GreenLight PVP — Photoselective Vaporization of the Prostate

GreenLight Photoselective Vaporization of the Prostate (PVP) is an FDA-cleared 532 nm laser-based BPH therapy that vaporizes obstructive prostatic tissue with simultaneous hemostatic coagulation.[37] The 281-man GOLIATH noninferiority trial enrolled prostates up to 100 g and found 180 W XPS PVP noninferior to TURP for symptom and flow outcomes through 24 months; meta-analyses reported less perioperative bleeding.[12][13][14][15][16] The AUA 2026 guideline states that clinicians should offer PVP as an option for LUTS/BPH , and it lists PVP among the options a clinician may offer to patients at high risk of bleeding or requiring anticoagulant or antiplatelet therapy .[1] For other BPH options, see BPH & Male LUTS — chooser.

Mechanism​

The GreenLight laser emits a 532 nm wavelength (green light) that is selectively absorbed by oxyhemoglobin but not by water. The result is rapid heating and vaporization of the highly vascular prostatic adenoma while sparing surrounding water-rich structures.[2][3] Tissue is converted to vapor and evacuated through the irrigant, creating an immediate cavity similar to TURP. The laser also coagulates blood vessels at the resection surface, and this is the proposed explanation for the lower bleeding rates compared with electrocautery-based TURP.[3][4]

Device evolution​

GenerationPowerCrystalFiberAdvance
1st (PV / KTP)60–80 WPotassium-titanyl-phosphateSide-firingOriginal platform; smaller prostates
2nd (HPS)120 WLithium triborate (LBO)Side-firingHigher power, faster vaporization, larger prostates
3rd (XPS)180 WLBOMoXy fiber (liquid-cooled, per the manufacturer)Faster vaporization; often a single fiber per case

The AUA 2026 panel agreed that the 80 W laser is less effective than the 120 W and 180 W lasers and that the higher-power laser is best when there is a choice.[1]

A meta-analysis of 8 studies comparing 180 W XPS with 120 W HPS found that XPS had shorter operative time (MD 12.7 min, p = 0.0008), shorter lasing time (MD 10.1 min, p = 0.03) and shorter catheterization (MD 0.43 d, p = 0.007). Overall complications were lower with XPS (OR 1.52 for HPS, p = 0.005). IPSS and Qmax did not differ, quality of life differed slightly (MD 0.43, p = 0.02), and PSA reduction was greater with XPS (MD −0.77, p = 0.003).[5] A prospective nonrandomized single-center comparison (120 XPS and 80 HPS cases) found that XPS required fewer fibers (1.0 versus 1.5) and fewer saline bags (4.1 versus 7.0).[6]

Procedure​

The procedure is performed under general, spinal or local anesthesia. Median total OR time was 62 min (IQR 46–85) in an expert-center database and 90 min in men with prostates larger than 100 mL.[7][8]

  1. Introduce a standard cystoscope (22–26 Fr) into the prostatic urethra.
  2. Advance the side-firing MoXy fiber through the working channel and extend its tip beyond the cystoscope before firing. Confirm saline cooling flow and protective eyewear for everyone in the room; keep the blue triangle visible, never fire while the red octagon is visible, and aim the beam at intended tissue. Avoid forward beam deflection at the bladder neck toward the ureteral orifices.[39]
  3. Vaporize layer by layer with a "painting" sweep at near-contact distance.
  4. Work from the bladder neck distally to the verumontanum, treating the lateral lobes and the median lobe as needed.
  5. In the Global GreenLight Group cohort, median lasing time was 34 min (IQR 23–48) and median energy 250 kJ (IQR 168–368).[7] A single fiber sufficed in 92.6% of procedures.[7]
  6. The catheter was removed on postoperative day 1 in 60.1%, with a median catheterization of 2 days.[7]
  7. Median length of stay was about 24 hours, and same-day discharge is described.[7][8]

Patient selection​

Boston Scientific XPS labeling lists acute UTI, prostate cancer, severe urethral stricture, and uncontrolled bleeding disorder or coagulopathy as contraindications; therapeutic antithrombotic use is addressed separately below.[40]

  • Moderate-to-severe LUTS.
  • Randomized evidence includes prostates up to 100 g in the GOLIATH trial.[14] Use in larger glands is feasible, but retreatment rates rise, particularly after 3 years.[8][24]
  • Patients on antithrombotic therapy have been treated in retrospective series, including those on warfarin, aspirin, clopidogrel and combinations.[9][10][11][24]
  • Obstructing median lobes can be treated.
  • Patients of high ASA class who may not tolerate TURP have been included in these series.[10][11]
  • A PVR > 250 mL was not a fixed exclusion in a 2024 retrospective GreenLight cohort that included men with chronic retention (defined as PVR > 300 mL in those able to void). At 12 months, 77/88 men (87.5%) treated for preoperative retention were catheter-free, versus 80/80 (100%) treated for LUTS without retention.[33]

Clinical efficacy: equivalence to TURP (GOLIATH)​

GOLIATH is the main RCT supporting PVP. It randomized 281 men to 180 W XPS PVP or TURP at 29 centers in 9 European countries. Patients and physicians were not blinded; men unable to stop anticoagulants or antiplatelet drugs for 3–5 days, apart from low-dose aspirin, were excluded.[12][13][14]

  • XPS was noninferior to TURP for IPSS, Qmax and the complication-free proportion at 6 months, and noninferiority was maintained at 12 and 24 months.
  • Prostate volume, PSA and PVR reductions did not differ significantly between arms at 12 months.
  • The 24-month complication-free rate was 83.6% (XPS) versus 78.9% (TURP).[14]
  • Time to stable health, catheterization time and length of stay were shorter with XPS.
  • Early reintervention within 30 days was three times higher after TURP (p = 0.025), and overall reintervention rates were not significantly different.[12]

Systematic reviews and meta-analyses​

A meta-analysis of randomized trials and prospective studies (22 publications, 2,665 patients) found no significant difference in IPSS, Qmax, QoL or PVR at 3, 24, 36 or 60 months; IIEF was pooled only through 24 months and was slightly lower after PVP at 24 months (mean difference −0.68, 95% CI −1.20 to −0.15).[15] PVP was associated with less blood loss, transfusion, clot retention, TUR syndrome, capsular perforation, catheterization time and hospitalization, and with a higher reintervention rate and longer procedure time (all p < 0.05).[15] A meta-analysis of 13 randomized trials (1,757 patients; some authors employed by the manufacturer) found less transfusion (RR 0.26; 95% CI 0.12–0.58) and clot retention (RR 0.12; 95% CI 0.05–0.32), and less sexual dysfunction (RR 0.66; 95% CI 0.45–0.98, p = 0.04). Procedure time was about 10 min longer with GreenLight, and reoperation did not differ significantly (RR 1.17; 95% CI 0.82–1.66).[16]

Global GreenLight Group: large international experience​

The Global GreenLight Group is a retrospective series of 3,627 men treated with the XPS 180 W system by eight expert surgeons in seven centers[7]:

  • Median prostate volume 64 mL (IQR 47–90).[7]
  • 30-day all-cause mortality 0.3%.[7]
  • Median catheterization 2 days.
  • IPSS, QoL, Qmax and PVR improved significantly, with improvement sustained through 60 months in men with long follow-up.
  • Median PSA reduction 43.9% at 3 months and 46.4% at 60 months.[7]

Long-term outcomes (5–10 yr)​

  • 120 W HPS, 5 yr (retrospective, 159/278 treated men had complete data): success by the study's composite IPSS, Qmax and QoL criteria was 101/123 (82.1%), 118/146 (80.8%) and 121/159 (76.1%) at 1, 3 and 5 years; 5/159 (3.1%) required repeat PVP and 2/159 (1.2%) required endoscopic reoperation for bladder neck contracture or urethral stricture.[17]
  • 80 W KTP versus TURP, 5-yr RCT: 238 men were randomized and 105 had 5-year data. IPSS, PVR and Qmax improvements were similar, and retreatment was 14.3% versus 11.9% (p = 0.9).[18]
  • 10-yr follow-up (retrospective, n = 1,154; 80 W then 120 W; median follow-up 24 months, maximum 125): IPSS, QoL and PSA improved significantly at 10 years, whereas Qmax and PVR did not. Retreatment-free survival was 93.9% at 5 years and 79.0% at 10 years.[19]
  • 80 W KTP, 5 yr (n = 246 of 321 with complete follow-up): AUA symptom score improved 79%, Qmax 172%, and retreatment was 8.9%.[20]

Follow-up​

EAU 2026 advises review four to six weeks after catheter removal, assessing symptom score, uroflowmetry, PVR, and erectile and ejaculatory function; its recommendation to follow up surgical patients is weak.[32]

Retreatment and durability​

SettingVolumeFollow-upRetreatment
Global GreenLight Group (XPS, expert centers)64 mL medianlonger follow-up available1.5% in that subset[7]
120 W HPSnot stated5 yr5/159 (3.1%) repeat PVP among men with complete follow-up[17]
80 W KTP55 mL mean5 yr8.9%[20]
80 W KTP vs TURP RCTmixed5 yr14.3% vs 11.9%[18]
XPS, very large (> 100 mL)121 mL median3 yr9.3%[8]
PVP in matched comparison with GreenLEP (> 80 g)107 g mean2 yr10.1%[25]
Single-center, 3 laser models (includes stricture and bladder neck contracture)mixed61 mo median13.8% overall[22]
Retrospective 10-yr seriesmixed10 yrestimated 21% cumulative retreatment (79% retreatment-free survival)[19]

EAU 2026 cites a 36-month RCT of the 120 W HPS laser in which reoperation was higher after PVP than after TURP (11% vs 1.8%), and a Finnish registry of 21,869 men in which cumulative reoperation was 23.5% after PVP and 17.8% after TURP over long follow-up. It also cites a real-world analysis with 4-year reintervention of 7.8% after PVP and 7.5% after TURP.[32] In the Global GreenLight Group XPS series, surgical BPH retreatment was 1.5% among men with longer follow-up available.[7] In a selected 120 W HPS cohort, 5/159 (3.1%) underwent repeat PVP over five years.[17] An 80 W randomized comparison reported 14.3% retreatment at five years.[18] A mixed 80/120 W series reported 79.0% retreatment-free survival at ten years.[19] A separate 80 W series reported 22/246 (8.9%) retreatment at five years.[20] In a 2025 systematic review of studies with at least five-year follow-up, mean GreenLight reoperation was 12.6% (range 3.8% to 33.3%); evidence for the 180 W system was limited to three five-year studies.[34] In glands larger than 100 mL it reached 5.4% at 2 years and 9.3% at 3 years, and the authors noted rising retreatment after 3 years.[8] In a randomized comparison in 80–150 mL glands, 3-year redo surgery for recurrent adenoma was 6.7% after GreenLight vapo-enucleation and none after HoLEP.[21] Reported predictors of retreatment include larger gland volume, lower energy density (2.4 versus 3.4 kJ/mL in retreated men), longer lasing time and less experienced surgeons.[8][22][23]

Safety profile​

PVP has a better perioperative safety profile than TURP, particularly for bleeding[15][16]:

  • Saline irrigation avoids classic hyponatremic TUR syndrome, but perioperative fluid overload still requires attention; a 162-man anticoagulated PVP series reported one case of heart failure attributed to excessive intravenous fluid.[11]
  • Transfusion is less frequent (RR 0.26 versus TURP) and clot retention is 88% lower (RR 0.12).[16]
  • Dysuria is the most common adverse event and is more frequent than after TURP; urgency, UTI and hematuria also occur.[1][15]
  • One single-center series reported reoperation for bladder neck contracture in 7.7% and urethral stricture in 5.6%; another reported bladder neck contracture in 3.4% and de novo urethral stricture in 2.1%. In a 500-patient 80 W series, bladder neck and urethral strictures occurred in 3.6% and 4.4%, and the authors described late complications as comparable to TURP.[22][23][24]
  • 30-day all-cause mortality was 0.3% in the Global GreenLight Group.[7]
  • Clavien-Dindo grade III–V complications did not differ significantly between PVP and TURP.[16]

Antithrombotic therapy​

All of the following are retrospective series:

  • Lee 2016 (n = 384; aspirin 38%, clopidogrel 9%, warfarin 15%, three-drug combinations 1.7%): patients on and off anticoagulation did not differ significantly in UTI, retention, stricture or reoperation over up to 2 years.[9]
  • Meskawi 2019 (n = 422, of whom 148 were on aspirin, other antiplatelet agents or anticoagulants): antithrombotic status did not predict serious bleeding events on multivariable analysis. Minor hematuria, readmissions, length of stay and catheterization time were higher in these patients.[10]
  • Chung 2011 (n = 162 on systemic anticoagulation, including combinations): mean hematocrit decrease was 1.94%, delayed bleeding occurred in 4% and transfusion in 2%.[11]
  • Ruszat 2008 (n = 500, 80 W; 45% on ongoing oral anticoagulation): no severe intraoperative complications were observed.[24]
  • EAU 2026 rates the evidence for the 80 W and 120 W lasers in patients on antiplatelet or anticoagulant therapy as level 2 and for the 180 W laser as level 3. It notes that these patients were excluded from or few in the RCTs, that one series found more bladder irrigation in anticoagulated men (17.2% vs 5.4%), and that a 180 W series without interrupting anticoagulation reported a 30.5% perioperative adverse-event rate with significant high-grade events.[32]
  • A review by authors with industry ties concluded that PVP was not associated with serious bleeding events requiring transfusion or medical treatment in patients on anticoagulant or antiplatelet therapy.[3]
  • A 2026 meta-analysis of 15 observational studies (6,091 men across endoscopic procedures) found comparable transfusion, hemostatic intervention, and urinary-complication rates in PVP patients continuing antithrombotics.[41]
  • In a 2024 propensity-matched PVP cohort (245 men; 95 anticoagulated), anticoagulation was associated with hematuria (adjusted OR 3.5, 95% CI 1.7–7.5) but not overall complications at three months.[42]

VTE prophylaxis​

No PVP-specific VTE-prophylaxis recommendation exists; apply the general urologic-surgery risk framework on the VTE Prophylaxis page.

Sexual function​

PVP sexual-function data are more heterogeneous than those for UroLift, Aquablation and iTIND.

  • A 13-RCT meta-analysis reported less sexual dysfunction than with TURP (RR 0.66; 95% CI 0.45–0.98).[16]
  • A 22-publication meta-analysis found no IIEF difference versus TURP at 3, 6, or 12 months, but a slightly lower score after PVP at 24 months (mean difference −0.68, 95% CI −1.20 to −0.15); no 36- or 60-month IIEF comparison was pooled.[15]
  • A systematic review noted a trend toward decline in erectile function in men with sustained preoperative erection, with heterogeneous data.[4]
  • Retrograde ejaculation is the most common sexual side effect. In a matched prospective comparison of sexually active men with glands larger than 80 g, among those assessed for ejaculation at 12 months, antegrade ejaculation was preserved in 26.9% after standard PVP and 1.2% after GreenLEP.[25]

Ejaculatory hood-sparing PVP​

A modified technique preserves the paracollicular and supracollicular tissue proximal to the verumontanum.

  • Abolazm 2020 (double-blinded RCT, 25 hood-sparing and 24 standard patients): among patients assessed for ejaculation, antegrade ejaculation was reported in 85% versus 31.6% (p = 0.001), with comparable urodynamic relief of obstruction at 6 months. The authors describe the technique as feasible for small to moderate glands in well-informed, sexually interested patients.[26]
  • Brant 2020 (25 patients treated with either GreenLight PVP or bipolar button vaporization, 3-month follow-up): the combined cohort had 80% antegrade-ejaculation preservation and improved total MSHQ scores.[27]

GreenLEP: laser enucleation extension​

GreenLEP combines vaporization with en bloc enucleation using 532 nm GreenLight laser technology and has been applied to prostates larger than 80 mL.[29]

  • Wang 2025 systematic review included 13 studies (11 in the meta-analysis): GreenLEP had better energy efficiency and better Qmax, PVR and PSA at final follow-up than standard PVP or anatomical PVP, and the lowest reoperation rate (OR 27.30; 95% CI 8.52–87.51), with a wide confidence interval.[28]
  • Misrai 2016, retrospective comparison of 60 patients per group with glands larger than 80 mL: GreenLEP had a shorter OR time (60 versus 82 min, p < 0.0001) and a greater Qmax improvement at 6 months (+78% versus +64%). Incontinence at 2 months was higher after GreenLEP (25% versus 3.4%) and was similar at 6 months.[29]
  • Randomized trial in 80–150 mL glands comparing GreenLEP, HoLEP and bipolar TURIS (Elshal 2020): GreenLEP had a longer operative time than HoLEP and TURIS and more 3-year redo surgery than HoLEP (6.7% versus 0%; p = 0.04 across the three arms).[21]
  • The single-surgeon series that described a simplified GreenLEP technique (n = 108) proposed it for surgeons who are familiar with PVP and are adopting enucleation.[30]

Comparison with other BPH options​

ProcedureVolume rangeAnticoagulationSurgical retreatmentSexual preservation
GreenLight PVPGOLIATH eligibility up to 100 g; EAU 2026 strong recommendation for 30–80 mL, with larger glands subject to the caveats discussed above[12][32]Retrospective series on warfarin, antiplatelets and combinations[9]1.5% in a selected XPS longer-follow-up subset; among 159 HPS five-year completers, 3.1% repeat PVP and 1.2% endoscopic reoperation for stricture/BNC; 9.3% at 3 yr in glands > 100 mL treated with XPS[7][17][8]Retrograde ejaculation common[25]; 85% antegrade ejaculation after hood-sparing PVP among assessed patients in a small RCT[26]
TURPup to 80 mLIndividualize perioperative antithrombotic management; bleeding risk varies by agent[32]1.5% at 5 yr in WATER[32]Anejaculation 36% among sexually active men in WATER[32]
HoLEPAny sizePossible with experienceMean reoperation 4.1% at mean 7.3 yr in long-term studies[34]Retrograde ejaculation common; SUI 1.5% in meta-analyses versus M-TURP[32]
Aquablation30–150 mL[32]General / regional4.4–6% at 5 yr in a MIST review[31]Antegrade preservation 72–99.6% across heterogeneous studies (3–48 mo)[35]
Optilume BPH20–80 g (PINNACLE eligibility)[44]Office-based3/100 (3%) at 2 yr[44]Preserved in trials
RezūmFDA-labeled 30–150 mL for men aged ≥50[43]Office-based4.4% surgical retreatment at 5 yr in the pivotal trial[38]; 11.1% initiated BPH medication[31]Preserved in trials
UroLift≤ 80 mL (≤ 100 RW)Reported on anticoagulation13.6% at 5 yr[31]Low anejaculation in pooled MIST data
iTIND25–75 mLOffice-based11.1% at 4 yr[31]Low anejaculation

EAU 2026 recommendations​

EAU 2026 strongly recommends offering 80 W KTP, 120 W LBO or 180 W LBO laser vaporization to men with moderate-to-severe LUTS/BPO and a 30–80 mL prostate as an alternative to TURP.[32] It weakly recommends laser vaporization for men on antiplatelet or anticoagulant therapy with a prostate under 80 mL.[32] EAU calls the 180 W XPS the current standard generator but notes that publications are few, especially above 100 mL, and that no RCT has included prostates above 100 mL.[32] AUA 2026 differs on the 80 W laser, which its panel judged less effective than the 120 W and 180 W lasers.[1]

Where GreenLight PVP fits​

Advantages​

  • AUA 2026 lists PVP among the options for patients who are at high risk of bleeding or need anticoagulant or antiplatelet therapy , and retrospective series support its use on continued antithrombotic therapy.[1][9][10][11]
  • Bleeding is lower than with TURP.[15][16]
  • In the 3,627-patient Global GreenLight series, catheters were removed on postoperative day 1 in 60.1% and median catheter duration was 2 days; across randomized trials, hospital stay averaged 2.1 days shorter than after TURP.[7][16]
  • In GOLIATH (prostate size ≤ 100 g), GreenLight XPS was noninferior to TURP for IPSS and Qmax at 24 months.[14]
  • Hospital-stay cost is lower than with TURP, partially offsetting the cost of the fiber.[3]

Limitations​

  • No tissue specimen is available for pathology, which matters when detection of occult prostate cancer is desired; in one TURP cohort with prior negative prostate biopsy, incidental cancer was found in 12/253 men (4.7%).[36]
  • In a single-arm XPS PVP cohort with glands > 100 mL, surgical BPH retreatment was 5.4% at 24 and 9.3% at 36 months.[8] In a separate randomized trial of 80–150 mL glands, redo surgery for recurrent adenoma after GreenLight vapo-enucleation was 6.7% versus 0% after HoLEP at 3 years (p = 0.04 across three arms).[8][21]
  • An EAU-cited meta-analysis of five RCTs found no significant difference in retrograde-ejaculation rates between GreenLight PVP and TURP.[32] In a small randomized trial, antegrade ejaculation was preserved in 31.6% with standard PVP and 85% with hood-sparing PVP.[26]
  • Procedure time is about 10 min longer than with TURP.[16]
  • Laser fiber costs are significant and are partially offset by shorter stay.
  • General or regional anesthesia is usually required, and the procedure is not office-based.

See Also​

BPH & Male LUTS — chooser · Prostate Enucleation / HoLEP · Aquablation · Rezūm · Optilume BPH · UroLift PUL · iTIND · Simple Prostatectomy · Prostate Artery Embolization

References​

1. Goueli R, Badlani GH, Welliver C, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline (2026). Part III: Procedural and surgical management. J Urol. 2026;216(2):161-170. doi:10.1097/JU.0000000000005099

2. Chughtai B, Te A. Photoselective vaporization of the prostate for treating benign prostatic hyperplasia. Expert Rev Med Devices. 2011;8(5):591-595. doi:10.1586/erd.11.25

3. Schwartz RN, Couture F, Sadri I, et al. Reasons to believe in vaporization: a review of the benefits of photo-selective and transurethral vaporization. World J Urol. 2021;39(7):2263-2268. doi:10.1007/s00345-020-03447-x

4. Rieken M, Bachmann A. Update on GreenLight laser vaporization (PVP) 2014. World J Urol. 2015;33(4):531-537. doi:10.1007/s00345-014-1437-8

5. Wang M, Xi Y, Qiu Z, et al. Comparative efficacy and safety of 180 W XPS vs. 120 W HPS GreenLight laser therapy for benign prostatic hyperplasia: a systematic review and meta-analysis. PeerJ. 2024;12:e18615. doi:10.7717/peerj.18615

6. Ben-Zvi T, Hueber PA, Liberman D, Valdivieso R, Zorn KC. GreenLight XPS 180 W vs HPS 120 W laser therapy for benign prostate hyperplasia: a prospective comparative analysis after 200 cases in a single-center study. Urology. 2013;81(4):853-858. doi:10.1016/j.urology.2012.12.031

7. Law KW, Tholomier C, Nguyen DD, et al. Global GreenLight Group: largest international GreenLight experience for benign prostatic hyperplasia to assess efficacy and safety. World J Urol. 2021;39(12):4389-4395. doi:10.1007/s00345-021-03688-4

8. Meskawi M, Hueber PA, Valdivieso R, et al. Multicenter international experience of 532 nm-laser photo-vaporization with GreenLight XPS in men with large prostates (prostate volume > 100 cc). World J Urol. 2017;35(10):1603-1609. doi:10.1007/s00345-017-2007-7

9. Lee DJ, Rieken M, Halpern J, et al. Laser vaporization of the prostate with the 180-W XPS-GreenLight laser in patients with ongoing platelet aggregation inhibition and oral anticoagulation. Urology. 2016;91:167-173. doi:10.1016/j.urology.2016.01.021

10. Meskawi M, Hueber PA, Valdivieso R, et al. Complications and functional outcomes of high-risk patient with cardiovascular disease on antithrombotic medication treated with the 532-nm laser photo-vaporization GreenLight XPS-180 W for benign prostate hyperplasia. World J Urol. 2019;37(8):1671-1678. doi:10.1007/s00345-018-2560-8

11. Chung DE, Wysock JS, Lee RK, et al. Outcomes and complications after 532 nm laser prostatectomy in anticoagulated patients with benign prostatic hyperplasia. J Urol. 2011;186(3):977-981. doi:10.1016/j.juro.2011.04.068

12. Bachmann A, Tubaro A, Barber N, et al. 180-W XPS GreenLight laser vaporisation versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: 6-month safety and efficacy results of a European multicentre randomised trial — the GOLIATH study. Eur Urol. 2014;65(5):931-942. doi:10.1016/j.eururo.2013.10.040

13. Bachmann A, Tubaro A, Barber N, et al. A European multicenter randomized noninferiority trial comparing 180 W GreenLight XPS laser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction: 12-month results of the GOLIATH study. J Urol. 2015;193(2):570-578. doi:10.1016/j.juro.2014.09.001

14. Thomas JA, Tubaro A, Barber N, 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(1):94-102. doi:10.1016/j.eururo.2015.07.054

15. Lai S, Peng P, Diao T, et al. Comparison of photoselective green light laser vaporisation versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta-analysis of randomised controlled trials and prospective studies. BMJ Open. 2019;9(8):e028855. doi:10.1136/bmjopen-2018-028855

16. Gill BC, Miller LE, Bhattacharyya S, Cash H, Eure GR. Complications of GreenLight laser vs transurethral resection of the prostate for treatment of lower urinary tract symptoms: meta-analysis of randomized trials. Urology. 2024;184:259-265. doi:10.1016/j.urology.2023.12.018

17. Park J, Cho SY, Cho MC, Jeong H, Son H. 5-year long-term efficacy of 120-W GreenLight photoselective vaporization of the prostate for benign prostate hyperplasia. PLoS One. 2017;12(9):e0184442. doi:10.1371/journal.pone.0184442

18. Mordasini L, Di Bona C, Klein J, et al. 80-W GreenLight laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic obstruction: 5-year outcomes of a single-center prospective randomized trial. Urology. 2018;116:144-149. doi:10.1016/j.urology.2018.01.037

19. Yamada Y, Furusawa J, Sugimura Y, Kuromatsu I. Photoselective vaporization of the prostate: long-term outcomes and safety during 10 years of follow-up. J Endourol. 2016;30(12):1306-1311. doi:10.1089/end.2016.0522

20. Hai MA. Photoselective vaporization of prostate: five-year outcomes of entire clinic patient population. Urology. 2009;73(4):807-810. doi:10.1016/j.urology.2008.08.502

21. Elshal AM, Soltan M, El-Tabey NA, Laymon M, Nabeeh A. Randomised trial of bipolar resection vs holmium laser enucleation vs GreenLight laser vapo-enucleation of the prostate for treatment of large benign prostate obstruction: 3-years outcomes. BJU Int. 2020;126(6):731-738. doi:10.1111/bju.15161

22. Özveren B, Karşıyakalı N, Türkeri L. Surgical reintervention requirements following GreenLight PVP: a single-center experience using three different laser device models. Arab J Urol. 2024;22(1):31-38. doi:10.1080/2090598X.2023.2222262

23. Elshal AM, Elmansy HM, Elhilali MM. Can we predict the outcome of 532 nm laser photoselective vaporization of the prostate? Time to event analysis. J Urol. 2012;188(5):1746-1753. doi:10.1016/j.juro.2012.07.030

24. Ruszat R, Seitz M, Wyler SF, et al. GreenLight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures. Eur Urol. 2008;54(4):893-901. doi:10.1016/j.eururo.2008.04.053

25. Huet R, Peyronnet B, Khene ZE, et al. Prospective assessment of the sexual function after GreenLight endoscopic enucleation and GreenLight 180 W XPS photoselective vaporization of the prostate. Urology. 2019;131:184-189. doi:10.1016/j.urology.2019.06.020

26. Abolazm AE, El-Hefnawy AS, Laymon M, Shehab-El-Din AB, Elshal AM. Ejaculatory hood sparing versus standard laser photoselective vaporization of the prostate: sexual and urodynamic assessment through a double-blinded, randomized trial. J Urol. 2020;203(4):792-801. doi:10.1097/JU.0000000000000685

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