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

Identifieur interne : 000064 ( Main/Exploration ); précédent : 000063; suivant : 000065

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

Auteurs : Ching-Hsin Chang [Taïwan] ; Tzu-Ping Lin [Taïwan] ; Yen-Hwa Chang [Taïwan] ; William Js Huang [Taïwan] ; Alex Tl Lin [Taïwan] ; Kuang-Kuo Chen [Taïwan]

Source :

RBID : PMC:4438483

Descripteurs français

English descriptors

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.


Url:
DOI: 10.1186/s12894-015-0032-7
PubMed: 25956819
PubMed Central: 4438483


Affiliations:


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Le document en format XML

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<name sortKey="Huang, William Js" sort="Huang, William Js" uniqKey="Huang W" first="William Js" last="Huang">William Js Huang</name>
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<term>Humans</term>
<term>Male</term>
<term>Prospective Studies</term>
<term>Risk Assessment</term>
<term>Severity of Illness Index</term>
<term>Sex Factors</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Facteurs de l'âge</term>
<term>Facteurs sexuels</term>
<term>Facteurs temps</term>
<term>Humains</term>
<term>Hyperplasie de la prostate</term>
<term>Indice de gravité médicale</term>
<term>Mâle</term>
<term>Obstruction du col de la vessie</term>
<term>Résection transuréthrale de prostate</term>
<term>Résultat thérapeutique</term>
<term>Rétention d'urine</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Thulium</term>
<term>Thérapie laser</term>
<term>Études de suivi</term>
<term>Études prospectives</term>
<term>Évaluation des risques</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Background</title>
<p>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).</p>
</sec>
<sec>
<title>Methods</title>
<p>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
<italic>t</italic>
-test and analysis of variance.</p>
</sec>
<sec>
<title>Results</title>
<p>The ages (mean ± SD) of the patients were 76.1 ± 9.4 and 72.6 ± 7.4 years (
<italic>p</italic>
 = 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 (
<italic>p</italic>
 = 0.449) in both groups. The overall complication rate was 20.7% in the ThuVEP group and 30.0% in the TURP group.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>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.</p>
</sec>
<sec>
<title>Trial registration</title>
<p>ISRCTN registry with study ID
<ext-link ext-link-type="uri" xlink:href="http://www.isrctn.com/ISRCTN52339705">ISRCTN52339705</ext-link>
. Date assigned: 06/03/2015.</p>
</sec>
</div>
</front>
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</back>
</TEI>
<affiliations>
<list>
<country>
<li>Taïwan</li>
</country>
</list>
<tree>
<country name="Taïwan">
<noRegion>
<name sortKey="Chang, Ching Hsin" sort="Chang, Ching Hsin" uniqKey="Chang C" first="Ching-Hsin" last="Chang">Ching-Hsin Chang</name>
</noRegion>
<name sortKey="Chang, Ching Hsin" sort="Chang, Ching Hsin" uniqKey="Chang C" first="Ching-Hsin" last="Chang">Ching-Hsin Chang</name>
<name sortKey="Chang, Ching Hsin" sort="Chang, Ching Hsin" uniqKey="Chang C" first="Ching-Hsin" last="Chang">Ching-Hsin Chang</name>
<name sortKey="Chang, Yen Hwa" sort="Chang, Yen Hwa" uniqKey="Chang Y" first="Yen-Hwa" last="Chang">Yen-Hwa Chang</name>
<name sortKey="Chang, Yen Hwa" sort="Chang, Yen Hwa" uniqKey="Chang Y" first="Yen-Hwa" last="Chang">Yen-Hwa Chang</name>
<name sortKey="Chang, Yen Hwa" sort="Chang, Yen Hwa" uniqKey="Chang Y" first="Yen-Hwa" last="Chang">Yen-Hwa Chang</name>
<name sortKey="Chen, Kuang Kuo" sort="Chen, Kuang Kuo" uniqKey="Chen K" first="Kuang-Kuo" last="Chen">Kuang-Kuo Chen</name>
<name sortKey="Chen, Kuang Kuo" sort="Chen, Kuang Kuo" uniqKey="Chen K" first="Kuang-Kuo" last="Chen">Kuang-Kuo Chen</name>
<name sortKey="Chen, Kuang Kuo" sort="Chen, Kuang Kuo" uniqKey="Chen K" first="Kuang-Kuo" last="Chen">Kuang-Kuo Chen</name>
<name sortKey="Huang, William Js" sort="Huang, William Js" uniqKey="Huang W" first="William Js" last="Huang">William Js Huang</name>
<name sortKey="Huang, William Js" sort="Huang, William Js" uniqKey="Huang W" first="William Js" last="Huang">William Js Huang</name>
<name sortKey="Huang, William Js" sort="Huang, William Js" uniqKey="Huang W" first="William Js" last="Huang">William Js Huang</name>
<name sortKey="Lin, Alex Tl" sort="Lin, Alex Tl" uniqKey="Lin A" first="Alex Tl" last="Lin">Alex Tl Lin</name>
<name sortKey="Lin, Alex Tl" sort="Lin, Alex Tl" uniqKey="Lin A" first="Alex Tl" last="Lin">Alex Tl Lin</name>
<name sortKey="Lin, Alex Tl" sort="Lin, Alex Tl" uniqKey="Lin A" first="Alex Tl" last="Lin">Alex Tl Lin</name>
<name sortKey="Lin, Tzu Ping" sort="Lin, Tzu Ping" uniqKey="Lin T" first="Tzu-Ping" last="Lin">Tzu-Ping Lin</name>
<name sortKey="Lin, Tzu Ping" sort="Lin, Tzu Ping" uniqKey="Lin T" first="Tzu-Ping" last="Lin">Tzu-Ping Lin</name>
<name sortKey="Lin, Tzu Ping" sort="Lin, Tzu Ping" uniqKey="Lin T" first="Tzu-Ping" last="Lin">Tzu-Ping Lin</name>
</country>
</tree>
</affiliations>
</record>

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