Korean J Urol.  2013 Apr;54(4):239-243.

Application of the Modified Clavien Classification System to 120W Greenlight High-Performance System Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia: Is It Useful for Less-Invasive Procedures?

• Kwon O
• Park S
• Jeong MY
• Cho SY
• Son H

Abstract

PURPOSE
To evaluate the accuracy and applicability of the modified Clavien classification system (CCS) in evaluating complications following photoselective vaporization of the prostate by use of the 120W GreenLight high-performance system (HPS-PVP).
MATERIALS AND METHODS
The medical records of 342 men who underwent HPS-PVP were retrospectively analyzed. Patients were older than 40 years and had a prostate volume >30 mL and an International Prostate Symptom Score (IPSS) > or =8. Patients with prostatic malignancy, neurogenic bladder, urethral stricture, large postvoid residual volume (>250 mL), previous prostatic surgery, or urinary tract infection were excluded. All operations were done by a single surgeon, and patients were followed up for uroflowmetry and IPSS postoperatively. All complications were recorded and classified according to the modified CCS, and methods of management were also recorded.
RESULTS
The patients' mean age was 71.6+/-7.3 years; mean prostate volume was 50.0+/-17.0 mL, and 95 cases (27.7%) had volumes greater than 70 mL. The mean total IPSS was 21.7+/-7.9 preoperatively and 12.3+/-8.1 at the first month postoperatively. A total of 59 patients (17.3%) experienced postoperative complications until the first month after the surgery. Among them, 49 patients (14.3%) showed grade I complications, 9 patients (2.6%) showed grade II complications, and 1 patient (0.3%) showed a grade IIIb complication. No patients had complications graded higher than IIIb.
CONCLUSIONS
Although the modified CCS is a useful tool for communication among clinicians in allowing comparison of surgical outcomes, this classification should be revised to gain higher accuracy and applicability in the evaluation of postoperative complications of HPS-PVP.

Keyword

Complications; Lasers; Prostatic hyperplasia; Transurethral resection of prostate; Transurethral vaporesection of prostate

MeSH Terms

Humans
Male
Medical Records
Postoperative Complications
Prostate
Prostatic Hyperplasia
Residual Volume
Retrospective Studies
Transurethral Resection of Prostate
Urethral Stricture
Urinary Bladder, Neurogenic
Urinary Tract Infections
Volatilization

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