Efficacy and Safety of High energy ThuVAP (Thulium laser Vaporization of Prostatic Adenoma) at 200W

Abstract

Objectives: BPH is a common condition afflicting the aging male. The aim of our study is to highlight the safety and efficacy of high power (200 Watt) ThuVAP as a valid alternative treatment option for BPH unresponsive to medical therapy and associated with LUTS.Methods: Patients with BPH unresponsive to conventional therapy were treated with ThuVAP at high power -200Watts (between July 2020 -December 2021). 106 patients were enrolled and 98 underwent surgery. ThuVAP was performed with a standard Iglesias 26ch resectoscope employing a 800µm fiber with a continuous mode 200Watt setting for vaporization and a 30Watt setting for hemostasis on a Quanta system Cyber TM thulium laser. Patients were evaluated pre-and post operatively by an senior consultant urologists.Results: A total of 98 patients were treated. Patient preoperative characteristics were: mean IPSS of 26, mean QOL of 5, preop Qmax 5.7±4.3ml/sec, PVR 173±35 ml, prostate size (as measure on transrectal ultrasound) 133±65 ml, prostate adenoma size 94±40 ml, mean PSA 4.14 ng/ml. Post operative characteristics were evaluated at 45 days after surgery and evidenced mean IPSS of 12, QOL 1.3, Qmax 19.7±3.2ml/sec, PVR 21±5ml, PSA 1.1ng/ml. All patients referred improvement regarding symptoms and QOL with ameliorated perception of voiding as confirmed by uroflowmetry values. No adverse events were recorded. Conclusions:Our study showed that 200watt ThuVAP is a safe, repeatable, and effective treatment modality in patients with symptomatic BPH unresponsive to conventional therapy.