Vapoenucleation of the prostate using a high-power thulium laser: a one-year follow-up study
Identifieur interne : 000021 ( Pmc/Checkpoint ); précédent : 000020; suivant : 000022Vapoenucleation 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.
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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<country xml:lang="fr">Taïwan</country>
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<author><name sortKey="Chen, Kuang Kuo" sort="Chen, Kuang Kuo" uniqKey="Chen K" first="Kuang-Kuo" last="Chen">Kuang-Kuo Chen</name>
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<country xml:lang="fr">Taïwan</country>
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<wicri:noRegion>Taipei</wicri:noRegion>
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<affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan</nlm:aff>
<country xml:lang="fr">Taïwan</country>
<wicri:regionArea>Department of Urology, National Yang-Ming University School of Medicine, Taipei</wicri:regionArea>
<wicri:noRegion>Taipei</wicri:noRegion>
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<series><title level="j">BMC Urology</title>
<idno type="eISSN">1471-2490</idno>
<imprint><date when="2015">2015</date>
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<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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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Urol</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Urol</journal-id>
<journal-title-group><journal-title>BMC Urology</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2490</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25956819</article-id>
<article-id pub-id-type="pmc">4438483</article-id>
<article-id pub-id-type="publisher-id">32</article-id>
<article-id pub-id-type="doi">10.1186/s12894-015-0032-7</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Vapoenucleation of the prostate using a high-power thulium laser: a one-year follow-up study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Chang</surname>
<given-names>Ching-Hsin</given-names>
</name>
<address><email>jossp1029@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff4"></xref>
<xref ref-type="aff" rid="Aff5"></xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Lin</surname>
<given-names>Tzu-Ping</given-names>
</name>
<address><email>tplin63@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chang</surname>
<given-names>Yen-Hwa</given-names>
</name>
<address><email>yhchang@vghtpe.gov.tw</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Huang</surname>
<given-names>William JS</given-names>
</name>
<address><email>jshuang@vghtpe.gov.tw</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lin</surname>
<given-names>Alex TL</given-names>
</name>
<address><email>lin.alextl@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chen</surname>
<given-names>Kuang-Kuo</given-names>
</name>
<address><email>kkchen@vghtpe.gov.tw</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<aff id="Aff1"><label></label>
Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan</aff>
<aff id="Aff2"><label></label>
Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan</aff>
<aff id="Aff3"><label></label>
Shu-Tien Urological Science Research Center, Taipei, Taiwan</aff>
<aff id="Aff4"><label></label>
Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan</aff>
<aff id="Aff5"><label></label>
Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan</aff>
</contrib-group>
<pub-date pub-type="epub"><day>9</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>9</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>15</volume>
<elocation-id>40</elocation-id>
<history><date date-type="received"><day>5</day>
<month>7</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>16</day>
<month>4</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Chang et al.; licensee BioMed Central. 2015</copyright-statement>
<license license-type="open-access"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><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>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Benign prostate enlargement</kwd>
<kwd>Quanta thulium surgical laser system</kwd>
<kwd>Thulium laser</kwd>
<kwd>Vapoenucleation</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<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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