Vapoenucleation of the prostate using a high-power thulium laser: a one-year follow-up study
Identifieur interne : 000064 ( Main/Exploration ); précédent : 000063; suivant : 000065Vapoenucleation 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 :
- BMC Urology [ 1471-2490 ] ; 2015.
Descripteurs français
- KwdFr :
- Facteurs de l'âge, Facteurs sexuels, Facteurs temps, Humains, Hyperplasie de la prostate (), Hyperplasie de la prostate (diagnostic), Indice de gravité médicale, Lasers à solide (usage thérapeutique), Mâle, Obstruction du col de la vessie (), Obstruction du col de la vessie (physiopathologie), Obstruction du col de la vessie (étiologie), Résection transuréthrale de prostate (), Résultat thérapeutique, Rétention d'urine (), Rétention d'urine (physiopathologie), Rétention d'urine (étiologie), Sujet âgé, Sujet âgé de 80 ans ou plus, Thulium, Thérapie laser (), Études de suivi, Études prospectives, Évaluation des risques.
- MESH :
- diagnostic : Hyperplasie de la prostate.
- physiopathologie : Obstruction du col de la vessie, Rétention d'urine.
- usage thérapeutique : Lasers à solide.
- étiologie : Obstruction du col de la vessie, Rétention d'urine.
- Facteurs de l'âge, Facteurs sexuels, Facteurs temps, Humains, Hyperplasie de la prostate, Indice de gravité médicale, Mâle, Obstruction du col de la vessie, Résection transuréthrale de prostate, Résultat thérapeutique, Rétention d'urine, Sujet âgé, Sujet âgé de 80 ans ou plus, Thulium, Thérapie laser, Études de suivi, Études prospectives, Évaluation des risques.
English descriptors
- KwdEn :
- Age Factors, Aged, Aged, 80 and over, Follow-Up Studies, Humans, Laser Therapy (methods), Lasers, Solid-State (therapeutic use), Male, Prospective Studies, Prostatic Hyperplasia (complications), Prostatic Hyperplasia (diagnosis), Prostatic Hyperplasia (surgery), Risk Assessment, Severity of Illness Index, Sex Factors, Thulium, Time Factors, Transurethral Resection of Prostate (methods), Treatment Outcome, Urinary Bladder Neck Obstruction (etiology), Urinary Bladder Neck Obstruction (physiopathology), Urinary Bladder Neck Obstruction (surgery), Urinary Retention (etiology), Urinary Retention (physiopathology), Urinary Retention (surgery).
- MESH :
- chemical : Thulium.
- complications : Prostatic Hyperplasia.
- diagnosis : Prostatic Hyperplasia.
- etiology : Urinary Bladder Neck Obstruction, Urinary Retention.
- methods : Laser Therapy, Transurethral Resection of Prostate.
- physiopathology : Urinary Bladder Neck Obstruction, Urinary Retention.
- surgery : Prostatic Hyperplasia, Urinary Bladder Neck Obstruction, Urinary Retention.
- therapeutic use : Lasers, Solid-State.
- Age Factors, Aged, Aged, 80 and over, Follow-Up Studies, Humans, Male, Prospective Studies, Risk Assessment, Severity of Illness Index, Sex Factors, Time Factors, Treatment Outcome.
Abstract
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).
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
The ages (mean ± SD) of the patients were 76.1 ± 9.4 and 72.6 ± 7.4 years (
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.
ISRCTN registry with study ID
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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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Laser Therapy (methods)</term>
<term>Lasers, Solid-State (therapeutic use)</term>
<term>Male</term>
<term>Prospective Studies</term>
<term>Prostatic Hyperplasia (complications)</term>
<term>Prostatic Hyperplasia (diagnosis)</term>
<term>Prostatic Hyperplasia (surgery)</term>
<term>Risk Assessment</term>
<term>Severity of Illness Index</term>
<term>Sex Factors</term>
<term>Thulium</term>
<term>Time Factors</term>
<term>Transurethral Resection of Prostate (methods)</term>
<term>Treatment Outcome</term>
<term>Urinary Bladder Neck Obstruction (etiology)</term>
<term>Urinary Bladder Neck Obstruction (physiopathology)</term>
<term>Urinary Bladder Neck Obstruction (surgery)</term>
<term>Urinary Retention (etiology)</term>
<term>Urinary Retention (physiopathology)</term>
<term>Urinary Retention (surgery)</term>
</keywords>
<keywords scheme="KwdFr" 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>Hyperplasie de la prostate (diagnostic)</term>
<term>Indice de gravité médicale</term>
<term>Lasers à solide (usage thérapeutique)</term>
<term>Mâle</term>
<term>Obstruction du col de la vessie ()</term>
<term>Obstruction du col de la vessie (physiopathologie)</term>
<term>Obstruction du col de la vessie (étiologie)</term>
<term>Résection transuréthrale de prostate ()</term>
<term>Résultat thérapeutique</term>
<term>Rétention d'urine ()</term>
<term>Rétention d'urine (physiopathologie)</term>
<term>Rétention d'urine (étiologie)</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>
<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Thulium</term>
</keywords>
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</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Hyperplasie de la prostate</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Urinary Bladder Neck Obstruction</term>
<term>Urinary Retention</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Laser Therapy</term>
<term>Transurethral Resection of Prostate</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Obstruction du col de la vessie</term>
<term>Rétention d'urine</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Urinary Bladder Neck Obstruction</term>
<term>Urinary Retention</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Prostatic Hyperplasia</term>
<term>Urinary Bladder Neck Obstruction</term>
<term>Urinary Retention</term>
</keywords>
<keywords scheme="MESH" qualifier="therapeutic use" xml:lang="en"><term>Lasers, Solid-State</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Lasers à solide</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Obstruction du col de la vessie</term>
<term>Rétention d'urine</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Follow-Up Studies</term>
<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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</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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