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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

Vapoenucleation of the prostate using a high-power thulium laser: a one-year follow-up study

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Ching-Hsin Chang, Tzu-Ping Lin, Yen-Hwa Chang, William JS Huang, Alex TL Lin, Kuang-Kuo Chen
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

Study conception and design: TPL, ATLL, KKC. Acquisition of data: TPL, YHC, WJSH, ATLL. Analysis and interpretation of data: CHC. Drafting of manuscript: CHC. Critical revision: TPL, ATLL. All authors read and approved the final manuscript.

Abstract

Background

Prostate vaporization and enucleation is a novel treatment option for bladder outlet obstruction caused by benign prostate enlargement. This surgical technique, however, has not yet been standardized. We present our findings of using a high-power thulium laser to accomplish vapoenucleation of the prostate (ThuVEP).

Methods

We prospectively collected and analyzed data from 29 patients who underwent ThuVEP between August 2010 and May 2012. The control group included 30 patients who underwent traditional transurethral resection of the prostate (TURP). Operative variables, patient profiles, preoperative and postoperative urine flow rates, prostate volume (measured using transrectal ultrasonography), and the international prostate symptom score (IPSS) were recorded and analyzed using a two-tailed Student’s t-test and analysis of variance.

Results

The ages (mean ± SD) of the patients were 76.1 ± 9.4 and 72.6 ± 7.4 years (p = 0.28) in the ThuVEP and TURP groups, respectively. The average urinary flow rates before and 12 months after the operation (volume/maximum flow/average flow) were 243.3/10.5/5.0 and 302.8/17.6/9.4 (in mL, mL/s, mL/s, respectively) in the ThuVEP group and 247.2/10.8/4.6 and 369.9/20.8/12.0, respectively, in the TURP group. Preoperative and postoperative IPSSs were 17.1 ± 5.0 and 6.5 ± 3.8, respectively, in the ThuVEP group and 18.2 ± 4.5 and 6.2 ± 3.3, respectively, in the TURP group. The mean ratio of the estimated postoperative residual prostate volume to the preoperative total volume was 0.47 (p = 0.449) in both groups. The overall complication rate was 20.7% in the ThuVEP group and 30.0% in the TURP group.

Conclusions

One year of follow-up showed that ThuVEP and TURP effectively alleviated subjective and objective voiding symptoms with a low rate of complications. Thus, vapoenucleation using a high-power laser is feasible in elderly patients.

Trial registration

ISRCTN registry with study ID ISRCTN52339705. Date assigned: 06/03/2015.
Literatur
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