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

Ching Hsin Chang, Tzu Ping Lin, Yen Hwa Chang, William Js Huang, Alex Tl Lin, Kuang Kuo Chen

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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.

Original languageEnglish
Article number40
JournalBMC Urology
Volume15
Issue number1
DOIs
Publication statusPublished - May 9 2015

Fingerprint

Thulium
Transurethral Resection of Prostate
Prostate
Lasers
Urinary Bladder Neck Obstruction
Volatilization
Residual Volume
Registries
Ultrasonography
Analysis of Variance
Urine
Students
Control Groups

Keywords

  • Benign prostate enlargement
  • Quanta thulium surgical laser system
  • Thulium laser
  • Vapoenucleation

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

Cite this

Vapoenucleation of the prostate using a high-power thulium laser : A one-year follow-up study. / Chang, Ching Hsin; Lin, Tzu Ping; Chang, Yen Hwa; Huang, William Js; Lin, Alex Tl; Chen, Kuang Kuo.

In: BMC Urology, Vol. 15, No. 1, 40, 09.05.2015.

Research output: Contribution to journalArticle

Chang, Ching Hsin ; Lin, Tzu Ping ; Chang, Yen Hwa ; Huang, William Js ; Lin, Alex Tl ; Chen, Kuang Kuo. / Vapoenucleation of the prostate using a high-power thulium laser : A one-year follow-up study. In: BMC Urology. 2015 ; Vol. 15, No. 1.
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T2 - A one-year follow-up study

AU - Chang, Ching Hsin

AU - Lin, Tzu Ping

AU - Chang, Yen Hwa

AU - Huang, William Js

AU - Lin, Alex Tl

AU - Chen, Kuang Kuo

PY - 2015/5/9

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N2 - 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.

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KW - Quanta thulium surgical laser system

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