Association Between Cigarette Smoking and Early Improvement in Lower Urinary Tract Symptoms After 180-W GreenLight Photoselective Vaporization of the Prostate: Findings From a Dual-Center Study.

PURPOSE: This study aimed to evaluate the association between smoking status and early postoperative urinary symptoms following photoselective vaporization of the prostate.

METHODS

We conducted a retrospective study at two institutions in Japan. Patients who underwent photoselective vaporization of the prostate between 2020 and 2025 were classified as never-smokers, ex-smokers, or current-smokers. Baseline characteristics and surgical parameters were collected. Treatment outcomes were assessed using the International Prostate Symptom Score and the Overactive Bladder Symptom Score preoperatively and at one and 3 months after surgery. Multivariable analysis was performed to estimate the impact of smoking on low postoperative improvement, adjusting for covariables. A subgroup analysis evaluated voiding urodynamic parameters in patients with available data.

RESULTS

A total of 282 patients were included. Current-smokers showed significantly higher total International Prostate Symptom Score and its voiding subscore than other groups postoperatively. The storage subscore and Overactive Bladder Symptoms Score were similar among groups postoperatively. Current-smokers were more likely to require newly prescribed medication for overactive bladder symptoms within 1 month. Quality-of-life-scores were also worse in current-smokers at 1 month postoperatively. Multivariable analysis indicated that lower International Prostate Symptom Score and current smoking were independently associated with low postoperative improvement in the total International Prostate Symptom Score. No significant differences in urodynamic parameters were observed among groups.

CONCLUSIONS

Current smoking was associated with worse early urinary symptoms and quality-of-life-scores following photoselective vaporization of the prostate. Smoking cessation before surgery may help improve postoperative outcomes.