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Urodynamic Outcomes Following Photovaporization of the Prostate for Benign Prostatic Hyperplasia: A Retrospective Pressure-Flow Analysis
Journal article   Open access   Peer reviewed

Urodynamic Outcomes Following Photovaporization of the Prostate for Benign Prostatic Hyperplasia: A Retrospective Pressure-Flow Analysis

Jonathan S. Kim, Chaimaa M. Hossaini, Parker J. Simpson and Louis S. Liou
Uro, v 6(3), 25
02 Sep 2026
DOI: https://doi.org/10.3390/uro6030025
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https://doi.org/10.3390/uro6030025View
Published, Version of Record (VoR) Open Access Discount via Drexel Libraries Read and Publish Program 2026 Open CC BY V4.0

Abstract

Purpose: Photoselective vaporization of the prostate (PVP) with the GreenLight laser is an established minimally invasive treatment for benign prostatic hyperplasia (BPH), yet its effects on voiding physiology remain incompletely characterized. Most prior studies rely on symptom scores and uroflowmetry as surrogate endpoints. This study evaluates the urodynamic mechanisms underlying clinical improvement following GreenLight PVP using paired pressure-flow studies. Methods: We performed a single-center retrospective review of patients who underwent GreenLight XPS PVP for BPH-related bladder outlet obstruction at a community hospital. Inclusion required complete pre- and postoperative pressure-flow urodynamic studies (UDS) and symptom assessments (IPSS). Key urodynamic parameters included maximum flow rate (Qmax), average flow rate (Qavg), detrusor pressure at maximum flow (Pdet@Qmax), maximum detrusor pressure (max Pdet), bladder outlet obstruction index (BOOI), and post-void residual (PVR). Postoperative UDS were performed at 12 months. Statistical analysis employed the Wilcoxon signed-rank test for continuous variables. Results: Of 98 total patients (mean age 71.3 years), paired uroflowmetry was available in 87 patients and pressure-flow data in 64. IPSS improved significantly from 17.1 to 9.5 at 12 months (p < 0.05). Qmax increased by 76%, from 6.25 to 11.0 mL/s (p < 0.05), and Qavg increased by 35%, from 4.0 to 5.4 mL/s (p < 0.05). Max Pdet decreased significantly from 84.8 to 61.2 cmH2O (p < 0.05), and BOOI improved from 46.7 to 28.9 (p < 0.05). Pdet@Qmax and PVR did not change significantly. Conclusions: GreenLight PVP produces measurable restoration of voiding mechanics, evidenced by reduced peak detrusor pressures, improved outlet obstruction index, and enhanced urinary flow. These findings confirm that symptomatic improvement is underpinned by objective urodynamic de-obstruction. Larger prospective studies with longer follow-up are warranted.

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