Trial Outcomes & Findings for Photoselective Vaporization of the Prostate With the GreenLight XPS™ Laser System vs TURP for the Treatment of BPH (NCT NCT01218672)

NCT ID: NCT01218672

Last Updated: 2020-09-03

Results Overview

The IPSS is a patient-administered 7-question instrument used to classify severity of benign prostatic hyperplasia symptoms (BPH). Total scores can range from 0 to 35 (asymptomatic to very symptomatic).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

291 participants

Primary outcome timeframe

6 months

Results posted on

2020-09-03

Participant Flow

Ten subjects were determined to be ineligible for the study procedure and were withdrawn before randomization (i.e., study procedure not performed).

Participant milestones

Participant milestones
Measure
GreenLight XPS
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
Monopolar and bipolar loop TURP Systems
Overall Study
STARTED
139
142
Overall Study
Treated
136
133
Overall Study
COMPLETED
128
121
Overall Study
NOT COMPLETED
11
21

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Photoselective Vaporization of the Prostate With the GreenLight XPS™ Laser System vs TURP for the Treatment of BPH

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
GreenLight XPS
n=136 Participants
Photoselective vaporization of the prostate using GreenLight XPS laser system. GreenLight XPS vs. TURP: GreenLight XPS laser console GreenLight XPS consists of a 532 nm laser console capable of achieving power outputs between 20W and 180W. Laser technology is used to vaporize tissue for debulking prostatic hyperplasia and improvement of lower urinary tract symptoms. The 532 nm wavelength is in the visible spectrum as green light and is strongly absorbed by oxyhemoglobin.
TURP
n=133 Participants
Monopolar and bipolar Transuretheral resection of the prostate (TURP) The TURP procedure requires the use of a resectoscope, camera system and irrigation fluid. The system consists of a generator unit and a wire loop with an electrical current running through the loop used to cut prostate tissue and cauterize. Prostate tissue is cut away in small pieces and removed at the end of the procedure using irrigation. There are many manufacturers of TURP systems. Any monopolar and bipolar loop system that carry the CE mark may be used for the study.
Total
n=269 Participants
Total of all reporting groups
Age, Continuous
67.2 years
STANDARD_DEVIATION 6.8 • n=99 Participants
66.7 years
STANDARD_DEVIATION 6.6 • n=107 Participants
67.0 years
STANDARD_DEVIATION 6.6 • n=206 Participants
Sex: Female, Male
Female
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Sex: Female, Male
Male
136 Participants
n=99 Participants
133 Participants
n=107 Participants
269 Participants
n=206 Participants
Region of Enrollment
France
8 participants who were treated
n=99 Participants
7 participants who were treated
n=107 Participants
15 participants who were treated
n=206 Participants
Region of Enrollment
Spain
8 participants who were treated
n=99 Participants
8 participants who were treated
n=107 Participants
16 participants who were treated
n=206 Participants
Region of Enrollment
Belgium
5 participants who were treated
n=99 Participants
5 participants who were treated
n=107 Participants
10 participants who were treated
n=206 Participants
Region of Enrollment
Austria
4 participants who were treated
n=99 Participants
4 participants who were treated
n=107 Participants
8 participants who were treated
n=206 Participants
Region of Enrollment
Germany
28 participants who were treated
n=99 Participants
35 participants who were treated
n=107 Participants
63 participants who were treated
n=206 Participants
Region of Enrollment
Netherlands
13 participants who were treated
n=99 Participants
12 participants who were treated
n=107 Participants
25 participants who were treated
n=206 Participants
Region of Enrollment
Italy
12 participants who were treated
n=99 Participants
10 participants who were treated
n=107 Participants
22 participants who were treated
n=206 Participants
Region of Enrollment
Switzerland
10 participants who were treated
n=99 Participants
12 participants who were treated
n=107 Participants
22 participants who were treated
n=206 Participants
Region of Enrollment
United Kingdom
48 participants who were treated
n=99 Participants
40 participants who were treated
n=107 Participants
88 participants who were treated
n=206 Participants

PRIMARY outcome

Timeframe: 6 months

Population: The analysis includes all subjects who received a study treatment and for whom the outcome measure is available. Subjects were analyzed according to treatment received (as-treated analysis).

The IPSS is a patient-administered 7-question instrument used to classify severity of benign prostatic hyperplasia symptoms (BPH). Total scores can range from 0 to 35 (asymptomatic to very symptomatic).

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=134 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=131 Participants
Monopolar and bipolar loop TURP Systems
International Prostate Symptom Score (IPSS)
6.8 units on a scale
Standard Deviation 5.2
5.6 units on a scale
Standard Deviation 4.9

SECONDARY outcome

Timeframe: 6 months

Population: The analysis includes all subjects who received a study treatment and for whom the outcome measure is available. Subjects were analyzed according to treatment received (as-treated analysis).

Qmax measured from a void of at least 150 ml in volume.

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=116 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=117 Participants
Monopolar and bipolar loop TURP Systems
Maximum Urinary Flow Rate (Qmax)
23.3 ml/s
Standard Deviation 10.1
24.3 ml/s
Standard Deviation 11.4

SECONDARY outcome

Timeframe: 180 days

A complication is defined as a device or procedure-related adverse event meeting at least 1 of the following criteria: Perforation of tissue or a physiologic structure; Required a prolonged or secondary hospitalization; Required surgical or invasive intervention (e.g., breaking of the skin) and excluding urinary catheterization for transient retention lasting less than 7 days and/or IV medications related to anesthesia.

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=134 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=132 Participants
Monopolar and bipolar loop TURP Systems
Freedom From Complications
87.3 percentage of patients complication free
83.3 percentage of patients complication free

SECONDARY outcome

Timeframe: 6 months

Prostate volume measured via transrectal ultrasound

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=132 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=127 Participants
Monopolar and bipolar loop TURP Systems
Prostate Volume
23.0 ml
Standard Deviation 11.7
20.5 ml
Standard Deviation 11.7

SECONDARY outcome

Timeframe: 3 weeks post treatment

Population: A total of 136 subjects underwent GL-XPS and 133 subjects underwent TURP procedures. The SF36 questionnaire is comprised of three sections; available data is: SF36 (PCS): 133 GL-XPS, 129 TURP; SF36 (MHS): 134 GL-XPS, 130 TURP; SF36 Utility Index: 125 GL-XPS, 121 TURP.

Short Form Health Survey (SF-36 Acute) collected at 3-week visit. The SF-36 is a multi-purpose, short-form, health survey of functional health and well-being scores in a three-section format: Utility Index (score = 0-1 with higher score being better); Physical Component Summary (PCS) comprising of physical functioning, role-physical, bodily pain, and overall general health; Mental Component Summary (MCS) comprising of vitality, social functioning, role-emotional, and mental health. Each component in the PCS and MCS sections have a score of 1-100 with the higher score being better. The acute version uses a 1-week recall period.

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=136 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=133 Participants
Monopolar and bipolar loop TURP Systems
Post Treatment Outcomes of PVP and TURP
SF36 - PCS
50.3 score
Standard Deviation 8.1
50.5 score
Standard Deviation 7.3
Post Treatment Outcomes of PVP and TURP
SF36 - MHS
50.0 score
Standard Deviation 9.7
50.0 score
Standard Deviation 10.9
Post Treatment Outcomes of PVP and TURP
SF36 Utility Index
0.7 score
Standard Deviation 0.1
0.7 score
Standard Deviation 0.1

SECONDARY outcome

Timeframe: 3 weeks

Population: A total of 136 subjects underwent GL-XPS and 133 subjects underwent TURP procedures. Length of Stay data available for 134 GL-XPS and 132 TURP subjects.

Length of stay calculated as the difference from entering the recovery room date/time to discharge date/time

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=134 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=132 Participants
Monopolar and bipolar loop TURP Systems
Immediate Post Treatment Outcomes of PVP and TURP
65.5 hours
Standard Deviation 63.3
97.8 hours
Standard Deviation 63.4

SECONDARY outcome

Timeframe: Baseline and 24-months

Population: Table reflects available data at specified time-points

The IPSS, OABq, SF-36 Health Summary and EQ-5D instruments will be scored. IPSS classifies voiding symptoms with scores from 0-35 (asymptomatic to very symptomatic). The OABq captures overactive bladder symptom bother with scores from 0-100 (lower score is better). The SF-36 is a health survey with scores from 1-100 (higher score is better). EQ-5D assesses health status across a range of conditions and treatments with a score of 0-1 (higher score is better).

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=136 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=133 Participants
Monopolar and bipolar loop TURP Systems
Health Status of PVP and TURP
24-Month OABq
15.3 units on a scale
Standard Deviation 16.7
11.9 units on a scale
Standard Deviation 13.7
Health Status of PVP and TURP
Baseline IPSS
21.2 units on a scale
Standard Deviation 5.9
21.7 units on a scale
Standard Deviation 6.4
Health Status of PVP and TURP
Baseline OABq
44.2 units on a scale
Standard Deviation 20.5
42.9 units on a scale
Standard Deviation 20.8
Health Status of PVP and TURP
Baseline SF-36 Health Summary
52.2 units on a scale
Standard Deviation 7.8
51.9 units on a scale
Standard Deviation 7.1
Health Status of PVP and TURP
Baseline EQ5D
0.843 units on a scale
Standard Deviation 0.193
0.823 units on a scale
Standard Deviation 0.219
Health Status of PVP and TURP
24-Month IPSS
6.9 units on a scale
Standard Deviation 6.0
5.9 units on a scale
Standard Deviation 6.1
Health Status of PVP and TURP
24-Month SF-36 Health Summary
52.5 units on a scale
Standard Deviation 8.1
53.2 units on a scale
Standard Deviation 8.5
Health Status of PVP and TURP
24-Month EQ5D
0.875 units on a scale
Standard Deviation 0.194
0.857 units on a scale
Standard Deviation 0.210

SECONDARY outcome

Timeframe: Baseline, 12-months, and 24-months

The International Index of Erectile Function (IIEF-5) and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) instruments will be collected at baseline and the follow-up visits. The IIEF-5 is a self-administered 5 question instrument that assesses the relevant domains of male sexual function such as erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction with a total possible score of 5-25 (higher score is better). The ICIQ-SFis a self-administered 4-question tool designed for the assessment and quantification of incontinence and its impact on quality of life during the previous 4 weeks with a total score of 0-21 (higher score is worse).

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=136 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=133 Participants
Monopolar and bipolar loop TURP Systems
Tolerability of PVP and TURP Assessed Using International Index of Erectile Function (IIEF-5) and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF)
Baseline IIEF-5
13.2 units on a scale
Standard Deviation 7.6
13.7 units on a scale
Standard Deviation 7.5
Tolerability of PVP and TURP Assessed Using International Index of Erectile Function (IIEF-5) and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF)
Baseline ICIQ-UI SF
3.9 units on a scale
Standard Deviation 4.7
4.4 units on a scale
Standard Deviation 4.6
Tolerability of PVP and TURP Assessed Using International Index of Erectile Function (IIEF-5) and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF)
24-Months IIEF-5
12.9 units on a scale
Standard Deviation 7.5
13.9 units on a scale
Standard Deviation 8.2
Tolerability of PVP and TURP Assessed Using International Index of Erectile Function (IIEF-5) and International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF)
24-Months ICIQ-UI SF
2.8 units on a scale
Standard Deviation 4.1
2.0 units on a scale
Standard Deviation 3.3

SECONDARY outcome

Timeframe: 3-weeks, 3-months, 6-months, 12-months, and 24-months

Population: Descriptive statistics including frequency and percentages will be calculated. Results presented below are number of respondents who said Yes.

Subject responses to satisfaction with treatment as collected on follow-up visits. Data presented below indicates responses from subjects that would go through study treatment again at each of the defined follow-up visits.

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=125 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=120 Participants
Monopolar and bipolar loop TURP Systems
Subject Satisfaction of PVP and TURP
116 Participants
107 Participants

SECONDARY outcome

Timeframe: 2 Years

Subject experiencing a retreatment (removal of tissue via TUPR, PVP, or other intervention) for obstruction after the initial procedure was required

Outcome measures

Outcome measures
Measure
GreenLight XPS
n=136 Participants
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=133 Participants
Monopolar and bipolar loop TURP Systems
Rate of Retreatment of PVP and TURP
Months 0-6
4 Participants
7 Participants
Rate of Retreatment of PVP and TURP
Months 7-12
6 Participants
2 Participants
Rate of Retreatment of PVP and TURP
Months 13-24
4 Participants
1 Participants

Adverse Events

GreenLight XPS

Serious events: 24 serious events
Other events: 68 other events
Deaths: 0 deaths

TURP

Serious events: 25 serious events
Other events: 57 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
GreenLight XPS
n=136 participants at risk
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=133 participants at risk
Monopolar and bipolar Transuretheral resection of the prostate (TURP)
Renal and urinary disorders
Bleeding
2.2%
3/136 • Number of events 3 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
6.0%
8/133 • Number of events 9 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Urinary Tract Infection
2.2%
3/136 • Number of events 3 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
1.5%
2/133 • Number of events 2 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Irritative symptoms/pain/discomfort
0.74%
1/136 • Number of events 1 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
0.00%
0/133 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Stricture
5.9%
8/136 • Number of events 8 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
5.3%
7/133 • Number of events 7 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Urinary Incontinence
4.4%
6/136 • Number of events 7 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
1.5%
2/133 • Number of events 2 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Urinary Retention
3.7%
5/136 • Number of events 5 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
4.5%
6/133 • Number of events 6 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Other
0.00%
0/136 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
0.75%
1/133 • Number of events 1 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.

Other adverse events

Other adverse events
Measure
GreenLight XPS
n=136 participants at risk
Photoselective vaporization of the prostate using GreenLight XPS Laser System.
TURP
n=133 participants at risk
Monopolar and bipolar Transuretheral resection of the prostate (TURP)
Vascular disorders
Bleeding
9.6%
13/136 • Number of events 13 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
9.8%
13/133 • Number of events 13 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Urinary Tract Infection
18.4%
25/136 • Number of events 26 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
9.0%
12/133 • Number of events 14 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Irritative Symptoms/Pain/Discomfort
22.1%
30/136 • Number of events 33 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
22.6%
30/133 • Number of events 30 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Stricture (meatal, urethral, bladder neck)
0.74%
1/136 • Number of events 1 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
1.5%
2/133 • Number of events 2 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Urinary Incontinence
7.4%
10/136 • Number of events 10 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
3.0%
4/133 • Number of events 4 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Urinary Retention
9.6%
13/136 • Number of events 13 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
6.8%
9/133 • Number of events 9 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
Renal and urinary disorders
Other
5.9%
8/136 • Number of events 8 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.
6.0%
8/133 • Number of events 8 • From the date of the informed consent until the subject exits the study. (Mean follow-up was 23.3 months)
Adverse events determined as "Other" were not further defined during analysis.

Additional Information

Teresa Takle-Flach, Director, Clinical Operations

Boston Scientific Corporation

Phone: (952)930-6000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place