nach oben

World Journal of Urology

Erschienen in:

01.06.2014 | Original Article

A randomized trial comparing thulium laser resection to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: four-year follow-up results

verfasst von: Di Cui, Feng Sun, Jian Zhuo, Xiaowen Sun, Bangmin Han, Fujun Zhao, Yifeng Jing, Jun Lu, Shujie Xia

Erschienen in: World Journal of Urology | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Objective

To report the results of a randomized prospective trial with a 4-year follow-up, comparing the thulium laser resection of the prostate-tangerine technique (TmLRP-TT) with transurethral resection of prostate (TURP) for treatment of symptomatic benign prostatic hyperplasia (BPH).

Methods

BPH patients (96) were randomized for surgical treatment with TmLRP-TT (47) or TURP (49). All patients were assessed pre-operatively and followed at 12, 24, 36, and 48 months post-operatively. Several parameters related to BPH were collected at each follow-up, including International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rates (Qmax), and post-void residual volume (PVR). All late complications were also recorded.

Results

Dramatic improvement in micturition parameters was observed after TmLRP-TT compared with pre-operative values. Median IPSS decreased 75.6 % in the subsequent 12 months and 61.2 % in 48 months, while median QoL decreased by 80.4 and 59.1 %, respectively. Compared with baseline, numerical values of Qmax increased 1.07-fold and those of PVR decreased 73.1 % in the fourth year. Moreover, all micturition parameters in the TmLRP-TT group were similar to those of TURP patients at every annual assessment. Some late complications after the operations were also observed: one patient suffered from urethral strictures and one from bladder-neck contractures after TmLRP-TT. Re-operation rates were equal in the two groups.

Conclusions

Micturition remained stable after TmLRP-TT during the 4-year follow-up. Outcomes compared favourably with TURP, with lower peri-operative morbidity and equally low occurrence of late adverse effects. Thus, TmLRP-TT can be an available option for BPH patients, especially older, high-risk patients.

McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, Foster HE Jr, Gonzalez CM, Kaplan SA, Penson DF, Ulchaker JC, Wei JT (2011) Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 185(5):1793–1803. doi:10.1016/j.juro.2011.01.074 PubMedCrossRef

Herrmann TR, Liatsikos EN, Nagele U, Traxer O, Merseburger AS (2012) EAU guidelines on laser technologies. Eur Urol 61(4):783–795. doi:10.1016/j.eururo.2012.01.010 PubMedCrossRef

Xia SJ, Zhang YN, Lu J, Sun XW, Zhang J, Zhu YY, Li WG (2005) Thulium laser resection of prostate-tangerine technique in treatment of benign prostate hyperplasia. Zhonghua Yi Xue Za Zhi 85(45):3225–3228PubMed

Xia SJ (2009) Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment. Asian J Androl 11(3):277–281. doi:10.1038/aja.2009.17 PubMedCentralPubMedCrossRef

Bach T, Netsch C, Pohlmann L, Herrmann TR, Gross AJ (2011) Thulium:YAG vapoenucleation in large volume prostates. J Urol 186(6):2323–2327. doi:10.1016/j.juro.2011.07.073 PubMedCrossRef

Herrmann TR, Bach T, Imkamp F, Georgiou A, Burchardt M, Oelke M, Gross AJ (2010) Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol 28(1):45–51. doi:10.1007/s00345-009-0503-0 PubMedCrossRef

Fried NM (2006) Therapeutic applications of lasers in urology: an update. Expert Rev Med Devices 3(1):81–94. doi:10.1586/17434440.3.1.81 PubMedCrossRef

Xia SJ, Zhuo J, Sun XW, Han BM, Shao Y, Zhang YN (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 53(2):382–389. doi:10.1016/j.eururo.2007.05.019 PubMedCrossRef

Bach T, Xia SJ, Yang Y, Mattioli S, Watson GM, Gross AJ, Herrmann TR (2010) Thulium:YAG 2 mum cw laser prostatectomy: where do we stand? World J Urol 28(2):163–168. doi:10.1007/s00345-010-0522-x PubMedCrossRef

10.

Szlauer R, Gotschl R, Razmaria A, Paras L, Schmeller NT (2009) Endoscopic vaporesection of the prostate using the continuous-wave 2-microm thulium laser: outcome and demonstration of the surgical technique. Eur Urol 55(2):368–375. doi:10.1016/j.eururo.2008.10.034 PubMedCrossRef

11.

Dubey D, Muruganandham K (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Indian J Urol 24(3):428–429PubMedCentralPubMed

12.

Netsch C, Pohlmann L, Herrmann TR, Gross AJ, Bach T (2012) 120-W 2-μm thulium:yttrium-aluminium-garnet vapoenucleation of the prostate: 12-month follow-up. BJU Int 110(1):96–101. doi:10.1111/j.1464-410X.2011.10767.x PubMedCrossRef

13.

Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR (2012) Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 109(3):408–411. doi:10.1111/j.1464-410X.2011.10359.x PubMedCrossRef

14.

Hauser S, Rogenhofer S, Ellinger J, Strunk T, Muller SC, Fechner G (2012) Thulium laser (revolix) vapoenucleation of the prostate is a safe procedure in patients with an increased risk of hemorrhage. Urol Int 88(4):390–394. doi:10.1159/000336874 PubMedCrossRef

15.

Rieken M, Ebinger Mundorff N, Bonkat G, Wyler S, Bachmann A (2010) Complications of laser prostatectomy: a review of recent data. World J Urol 28(1):53–62. doi:10.1007/s00345-009-0504-z PubMedCrossRef

16.

Tan AH, Gilling PJ, Kennett KM, Frampton C, Westenberg AM, Fraundorfer MR (2003) A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol 170(4 Pt 1):1270–1274. doi:10.1097/01.ju.0000086948.55973.00 PubMedCrossRef

17.

Netsch C, Bach T, Pohlmann L, Herrmann T, Gross AJ (2012) Comparison of 120–200 W 2 μm thulium:yttrium-aluminum-garnet vapoenucleation of the prostate. J Endourol 26(3):224–229. doi:10.1089/end.2011.0173 PubMedCrossRef

18.

Ahyai SA, Lehrich K, Kuntz RM (2007) Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial. Eur Urol 52(5):1456–1463. doi:10.1016/j.eururo.2007.04.053 PubMedCrossRef

19.

Zhang F, Shao Q, Herrmann TR, Tian Y, Zhang Y (2012) Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center. Urology 79(4):869–874. doi:10.1016/j.urology.2011.12.018 PubMedCrossRef

20.

Malde S, Rajagopalan A, Patel N, Simoes A, Choi W, Shrotri N (2012) Potassium-titanyl-phosphate laser photoselective vaporization for benign prostatic hyperplasia: 5-year follow-up from a district general hospital. J Endourol 26(7):878–883. doi:10.1089/end.2011.0370 PubMedCrossRef

21.

Al-Ansari A, Younes N, Sampige VP, Al-Rumaihi K, Ghafouri A, Gul T, Shokeir AA (2010) GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia: a randomized clinical trial with midterm follow-up. Eur Urol 58(3):349–355. doi:10.1016/j.eururo.2010.05.026 PubMedCrossRef

22.

Ruszat R, Wyler SF, Seitz M, Lehmann K, Abe C, Bonkat G, Reich O, Gasser TC, Bachmann A (2008) Comparison of potassium-titanyl-phosphate laser vaporization of the prostate and transurethral resection of the prostate: update of a prospective non-randomized two-centre study. BJU Int 102(10): 1432–1438; discussion 1438–1439. doi:10.1111/j.1464-410X.2008.07905.x

23.

Pereira-Correia JA, de Moraes Sousa KD, Santos JB, de Morais Perpetuo D, Lopes-da-Silva LF, Krambeck RL, Muller VJ, Vaz FP (2012) GreenLight HPS 120-W laser vaporization vs transurethral resection of the prostate (<60 mL): a 2-year randomized double-blind prospective urodynamic investigation. BJU Int 110(8):1184–1189. doi:10.1111/j.1464-410X.2011.10878.x PubMedCrossRef

24.

Skolarikos A, Papachristou C, Athanasiadis G, Chalikopoulos D, Deliveliotis C, Alivizatos G (2008) Eighteen-month results of a randomized prospective study comparing transurethral photoselective vaporization with transvesical open enucleation for prostatic adenomas greater than 80 cc. J Endourol 22(10):2333–2340. doi:10.1089/end.2008.9709 PubMedCrossRef

25.

Shao Q, Zhang FB, Shang DH, Tian Y (2009) Comparison of holmium and thulium laser in transurethral enucleation of the prostate. Zhonghua Nan Ke Xue 15(4):346–349PubMed

26.

Lukacs B, Loeffler J, Bruyere F, Blanchet P, Gelet A, Coloby P, De la Taille A, Lemaire P, Baron JC, Cornu JN, Aout M, Rousseau H, Vicaut E (2012) Photoselective vaporization of the prostate with GreenLight 120-W laser compared with monopolar transurethral resection of the prostate: a multicenter randomized controlled trial. Eur Urol 61(6):1165–1173. doi:10.1016/j.eururo.2012.01.052 PubMedCrossRef

27.

Bachmann A, Muir GH, Collins EJ, Choi BB, Tabatabaei S, Reich OM, Gomez-Sancha F, Woo HH (2012) 180-W XPS GreenLight laser therapy for benign prostate hyperplasia: early safety, efficacy, and perioperative outcome after 201 procedures. Eur Urol 61(3):600–607. doi:10.1016/j.eururo.2011.11.041 PubMedCrossRef

28.

Liu CL, Xue DW, Liu YL, Wang P (2011) Greenlight photoselective vaporization prostatectomy versus thulium laser vaporesection of the prostate for aged high-risk BPH patients with the prostate heavier than 80 g. Zhonghua Nan Ke Xue 17(5):431–434PubMed

29.

Bach T, Wendt-Nordahl G, Michel MS, Herrmann TR, Gross AJ (2009) Feasibility and efficacy of Thulium:YAG laser enucleation (VapoEnucleation) of the prostate. World J Urol 27(4):541–545. doi:10.1007/s00345-008-0370-0 PubMedCrossRef

30.

Seki N, Nomura H, Yamaguchi A, Naito S (2008) Evaluation of the learning curve for photoselective vaporization of the prostate over the course of 74 cases. J Endourol 22(8):1731–1735. doi:10.1089/end.2007.0368 PubMedCrossRef

31.

van Rij S, Gilling PJ (2012) In 2013, holmium laser enucleation of the prostate (HoLEP) may be the new ‘gold standard’. Curr Urol Rep 13(6):427–432. doi:10.1007/s11934-012-0279-4 PubMedCrossRef

Titel: A randomized trial comparing thulium laser resection to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: four-year follow-up results
verfasst von: Di Cui
Feng Sun
Jian Zhuo
Xiaowen Sun
Bangmin Han
Fujun Zhao
Yifeng Jing
Jun Lu
Shujie Xia
Publikationsdatum: 01.06.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 3/2014
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-013-1103-6

Neu im Fachgebiet Urologie

25.04.2024 | Nierenkarzinom | Nachrichten

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

A randomized trial comparing thulium laser resection to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: four-year follow-up results

Abstract

Objective

Methods

Results

Conclusions

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Stufenschema weist Prostatakarzinom zuverlässig nach

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Urologie

Springer Medizin

Abstract

Objective

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2014

The role of urine markers, white light cystoscopy and fluorescence cystoscopy in recurrence, progression and follow-up of non-muscle invasive bladder cancer

Selective angioembolization for traumatic renal injuries: a survey on clinician practice

The contemporary role of ablative treatment approaches in the management of renal cell carcinoma (RCC): focus on radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), and cryoablation

Surgical management of metastatic renal cell carcinoma in the era of targeted therapies

Resistance patterns of nosocomial urinary tract infections in urology departments: 8-year results of the global prevalence of infections in urology study

The Integral Theory System Questionnaire: an anatomically directed questionnaire to determine pelvic floor dysfunctions in women

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Stufenschema weist Prostatakarzinom zuverlässig nach

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Urologie