Learning curve of ThuLEP (Thulium laser enucleation of the prostate): Single‐centre experience on initial consecutive 60 patients

Aydoğan, Tahsin Batuhan; Binbay, Murat

doi:10.1111/and.14366

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…According to this study, complication rates started to drop after 20 cases. After 40 instances in our study, it can be claimed that we are in a safer region when parameters like capsular perforation, temporary incontinence (which in our experiment lasted for a maximum of 4 months), and resectoscope-assisted cauterization requirements are considered 14 . Tuccio et al's holmium LEP (HoLEP) series were evaluated comparatively according to the enucleation technique used.…”

Section: Discussionmentioning

confidence: 89%

En bloc enucleation of the prostate with early apical release using a high-power (200 W) thulium device: studying a learning curve

Yıldırım,

Ezer,

Uslu

et al. 2023

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: The aim of this study was to reveal the learning curve of early apical release en bloc laser prostatectomy using a high-power thulium (200 W) laser device. METHODS: We obtained data on the initial 60 patients who had thulium laser enucleation of the prostate by a single surgeon between October 2021 and August 2022 to treat the signs and symptoms of benign prostatic hyperplasia at our clinic. The cases were split into three groups, each consisting of 20 patients. Prostate volumes, prostate-specific antigen and hemoglobin levels, the International Prostate Symptom Score, Quality of Life scores, the International Index of Erectile Function-5 scores, and uroflowmetry parameters were documented preoperatively. The enucleation weight, the enucleation and morcellation times, as well as the efficiency, hospitalization, and catheterization durations were calculated. The patients were re-evaluated at 6 months postoperatively, examined for functional results, and compared to baseline conditions. RESULTS: Enucleation times, morcellation times, enucleation weight, and enucleation efficiency were significantly different among the groups. However, there was no statistically significant difference in total operative time and morcellation efficiency. In terms of postoperative statistics, the reduction in hemoglobin was significantly greater in Group 1 compared to Group 2. Six months after surgery, all groups had comparable validated ratings (International Prostate Symptom Score, Quality of Life, and the International Index of Erectile Function-5) on postoperative examinations. There were no long-term complications in either group throughout the perioperative period. CONCLUSION: Completing 40 first cases would be sufficient for managing the learning curve for early apical release en bloc thulium laser enucleation of the prostate.

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Section: Discussionmentioning

confidence: 89%

En bloc enucleation of the prostate with early apical release using a high-power (200 W) thulium device: studying a learning curve

Yıldırım,

Ezer,

Uslu

et al. 2023

Rev. Assoc. Med. Bras.

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“…Thulium laser was first used in a clinical setting in 2005 [9]. Thulium laser is commonly used in resection, enucleation and vaporization because of its shallow penetration [10][11][12]. Comparative studies between thulium laser prostatectomy vs monopolar or bipolar TURP along with HoLEP have been published demonstrating significant advantage for the thulium laser in terms of blood loss, catheter time and hospital stay.…”

Section: Discussionmentioning

confidence: 99%

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

2022

J Surg

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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.

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“…Patients with missing baseline data were excluded from the study. The initial 20 cases of ThuLEP were excluded to limit the impact of the learning curve on outcomes ( 7 ).…”

Section: Methodsmentioning

confidence: 99%

Long-term functional outcomes and surgical retreatment after thulium laser enucleation of the prostate: A 10-year follow-up study

Manfredi,

Napolitano,

Ditonno

et al. 2024

Int. braz j urol.

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Background: To evaluate the 10-year functional outcomes (primary) and frequency and predictors of BPH surgical retreatment (secondary) after ThuLEP. Materials and Methods: A single-center retrospective analysis of consecutive patients undergoing ThuLEP between 2010 and 2013 was performed. Inclusion criteria were: age ≥ 40 years, prostate volume (PV) ≥ 80 mL, International Prostate Symptom Score (IPSS)-Total score ≥ 8 points. IPSS-Total score was the primary outcome, and BPH surgical retreatment rate was the secondary outcome. Paired t-test, McNemar test, and Wilcoxon signed-rank test were used to compare variables. Logistic regression analysis was performed to evaluate predictors of surgical retreatment.Results: A total of 410 patients with a mean ±SD age of 63.9 ± 9.7 years and a PV of 115.6 ± 28.6 mL were included. Mean ±SD follow-up was 108.2 ± 29.6 months. IPSS-Total score was significantly improved at 1 year compared to baseline (23.3 ± 4.

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Learning curve of ThuLEP (Thulium laser enucleation of the prostate): Single‐centre experience on initial consecutive 60 patients

Cited by 7 publications

References 18 publications

En bloc enucleation of the prostate with early apical release using a high-power (200 W) thulium device: studying a learning curve

En bloc enucleation of the prostate with early apical release using a high-power (200 W) thulium device: studying a learning curve

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

Long-term functional outcomes and surgical retreatment after thulium laser enucleation of the prostate: A 10-year follow-up study

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