Reasons to go for thulium-based anatomical endoscopic enucleation of the prostate

Becker, Benedikt; Netsch, Christopher; Bozzini, Giorgio; Herrmann, Thomas; Bach, Thorsten; Enikeev, Dmitry; Gross, Andreas J.

doi:10.1007/s00345-021-03704-7

Cited by 10 publications

(6 citation statements)

References 64 publications

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“…First, we found a higher incidence of BNS (2.99%) compared with the available literature. A recent review on ThuLEP reported that the incidence of BNS ranges from 0.8% to 1.8% (Becker et al, 2021). However, most studies were small series with a short-term follow-up (3-12 months).…”

Section: Discussionmentioning

confidence: 99%

Urethral and bladder neck stenosis after thulium laser enucleation of the prostate: Analysis of risk factors in a series of 1003 patients

et al. 2022

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We assessed the incidence and risks factors of bladder neck and urethral stenosis after Thulium laser enucleation of the prostate. Patients who underwent surgery at two centres were retrospectively reviewed (December 2014-June 2020).Exclusion criteria: previous urethral/prostatic surgery, pelvic irradiation, prostate cancer, neurogenic bladder, history of bladder neck and urethral stenosis, concomitant transurethral surgery, active urinary tract infection. Significant variables at univariate analysis (p < 0.05) were included in a multivariate logistic regression analysis to establish their association with bladder neck/urethral stenosis. One thousand and three patients were included. Median age was 69.0 (63.0-75.0) years. Median prostate volume was 65.0 (46.3-82.0) ml. Median follow-up was 31 (25-75) months. Thirty patients (2.99%) developed bladder neck stenosis [median time after surgery: 15 (11-17.75) months], 50 patients (4.98%) urethral stenosis [median time after surgery: 9 (7-11) months]. Men with bladder neckand urethral stenosis had significantly smaller prostate volume (median volume 43.5 ml vs. 66.0 ml, p = 0.008, and 52.0 ml vs. 66.0 ml, p = 0.009, respectively).At multivariable analysis, short surgical time predicted for bladder neck stenosis (OR 0.973; 95% CI 0.957-0.994, p = 0.002), and re-catheterization (OR 3.956; 95% CI 1.867-8.382, p < 0.001) for urethral stenosis, whereas prostate volume was significantly associated with a lower incidence of US (OR 0.984, 95% CI 0.972-0.998, p = 0.03).

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Section: Discussionmentioning

confidence: 99%

Urethral and bladder neck stenosis after thulium laser enucleation of the prostate: Analysis of risk factors in a series of 1003 patients

et al. 2022

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“…Recently endoscopic prostate laser treatments have gained popularity as a safe and valid alternative to TURP. Advantages of employing a laser are the irrigation with saline solution (0.9%) thus eliminating the risk of TUR-syndrome, a lower rate of intra-and post-operative hemorrhage due to the haemostatic characteristic of the laser thus permitting to treat patients with bleeding disorders or under anticoagulant therapy [5]. Despite the variety of treatments available there is no consensus about the best surgical for BPH treatment [5].…”

Section: Introductionmentioning

confidence: 99%

“…Advantages of employing a laser are the irrigation with saline solution (0.9%) thus eliminating the risk of TUR-syndrome, a lower rate of intra-and post-operative hemorrhage due to the haemostatic characteristic of the laser thus permitting to treat patients with bleeding disorders or under anticoagulant therapy [5]. Despite the variety of treatments available there is no consensus about the best surgical for BPH treatment [5]. Our aim is to report our results regarding efficacy and safety of using Thulium laser vaporization of the prostate (ThuVAP) at a high 200Watt power setting for the treatment of BPH as a valid alternative not having observed adverse events along with and a high patients satisfaction rate and improvement in terms of uroflowmetry, IPSS and QOL.…”

Section: Introductionmentioning

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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“…Regarding the question of which laser might be the best for surgical management of benign prostatic obstruction (BPO), there is a full range of surgical modalities to consider, although all panel members in this open debate in European Urology Open Science are advocates of anatomical endoscopic enucleation of the prostate (EEP) [1] , [2] , [3] , [4] , [5] , [6] . However, as the 2022 edition of the European Association of Urology (EAU) guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS) and BPO suggest ( Fig.…”

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confidence: 99%

Thulium YAG is the Best Laser for the Prostate Because of Versatility

Herrmann

Becker

Netsch

2023

European Urology Open Science

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Reasons to go for thulium-based anatomical endoscopic enucleation of the prostate

Cited by 10 publications

References 64 publications

Urethral and bladder neck stenosis after thulium laser enucleation of the prostate: Analysis of risk factors in a series of 1003 patients

Urethral and bladder neck stenosis after thulium laser enucleation of the prostate: Analysis of risk factors in a series of 1003 patients

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

Thulium YAG is the Best Laser for the Prostate Because of Versatility

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