An Analytical Comparison of Short-term Effectiveness and Safety Between Thulium:YAG Laser Vaporesection of the Prostate and Bipolar Transurethral Resection of the Prostate in Patients With Benign Prostatic Hyperplasia
Identifieur interne : 000155 ( Pmc/Checkpoint ); précédent : 000154; suivant : 000156An Analytical Comparison of Short-term Effectiveness and Safety Between Thulium:YAG Laser Vaporesection of the Prostate and Bipolar Transurethral Resection of the Prostate in Patients With Benign Prostatic Hyperplasia
Auteurs : Joon Woo Kim [Corée du Sud] ; Yeon Joo Kim [Corée du Sud] ; Yoon Hyung Lee [Corée du Sud] ; Joon Beom Kwon [Corée du Sud] ; Sung Ryong Cho [Corée du Sud] ; Jae Soo Kim [Corée du Sud]Source :
- Korean Journal of Urology [ 2005-6737 ] ; 2014.
Abstract
In recent years, laser surgery has been widely used to treat benign prostatic hyperplasia (BPH). A thulium:yttrium-aluminium-garnet (Tm:YAG) laser was recently introduced for BPH surgery. We compared the effectiveness and safety of Tm:YAG laser vaporesection of the prostate (ThuVaRP) with that of bipolar transurethral resection of the prostate (TURP).
From January 2010 to December 2012, 86 patients underwent surgical treatment for symptomatic BPH by a single surgeon. We retrospectively analyzed and compared the medical records of 43 patients who underwent ThuVaRP and 43 patients who underwent bipolar TURP. All patients were assessed by using the International Prostate Symptom Score, transrectal ultrasonography, the serum prostate-specific antigen (PSA) level, uroflowmetry, and postvoid residual volume before and 1 month after surgery. All complications were compared between the two groups.
ThuVaRP was superior to TURP in catheterization time (p<0.001) and length of hospital stay (p<0.001). However, operation time was longer with ThuVaRP than with TURP (p<0.001). In patients with a large prostate (>50 g), operation time was much longer with ThuVaRP. One month after surgery, the decrease in PSA was greater (p=0.045) with ThuVaRP than with TURP, and the increase in maximal urine flow rate was greater (p<0.001) with ThuVaRP than with TURP. The postoperative complication transient urinary incontinence was significantly different between the ThuVaRP group (nine cases, 20.9%) and the TURP group (two cases, 4.7%). Other complications were comparable between groups.
The effectiveness and safety of ThuVaRP and TURP were comparable. ThuVaRP is a promising alternative surgical technique to TURP for BPH.
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DOI: 10.4111/kju.2014.55.1.41
PubMed: 24466396
PubMed Central: 3897629
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">An Analytical Comparison of Short-term Effectiveness and Safety Between Thulium:YAG Laser Vaporesection of the Prostate and Bipolar Transurethral Resection of the Prostate in Patients With Benign Prostatic Hyperplasia</title><author><name sortKey="Kim, Joon Woo" sort="Kim, Joon Woo" uniqKey="Kim J" first="Joon Woo" last="Kim">Joon Woo Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Yeon Joo" sort="Kim, Yeon Joo" uniqKey="Kim Y" first="Yeon Joo" last="Kim">Yeon Joo Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Yoon Hyung" sort="Lee, Yoon Hyung" uniqKey="Lee Y" first="Yoon Hyung" last="Lee">Yoon Hyung Lee</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Kwon, Joon Beom" sort="Kwon, Joon Beom" uniqKey="Kwon J" first="Joon Beom" last="Kwon">Joon Beom Kwon</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Cho, Sung Ryong" sort="Cho, Sung Ryong" uniqKey="Cho S" first="Sung Ryong" last="Cho">Sung Ryong Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Jae Soo" sort="Kim, Jae Soo" uniqKey="Kim J" first="Jae Soo" last="Kim">Jae Soo Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24466396</idno><idno type="pmc">3897629</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897629</idno><idno type="RBID">PMC:3897629</idno><idno type="doi">10.4111/kju.2014.55.1.41</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000377</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000377</idno><idno type="wicri:Area/Pmc/Curation">000377</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000377</idno><idno type="wicri:Area/Pmc/Checkpoint">000155</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000155</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">An Analytical Comparison of Short-term Effectiveness and Safety Between Thulium:YAG Laser Vaporesection of the Prostate and Bipolar Transurethral Resection of the Prostate in Patients With Benign Prostatic Hyperplasia</title><author><name sortKey="Kim, Joon Woo" sort="Kim, Joon Woo" uniqKey="Kim J" first="Joon Woo" last="Kim">Joon Woo Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Yeon Joo" sort="Kim, Yeon Joo" uniqKey="Kim Y" first="Yeon Joo" last="Kim">Yeon Joo Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Yoon Hyung" sort="Lee, Yoon Hyung" uniqKey="Lee Y" first="Yoon Hyung" last="Lee">Yoon Hyung Lee</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Kwon, Joon Beom" sort="Kwon, Joon Beom" uniqKey="Kwon J" first="Joon Beom" last="Kwon">Joon Beom Kwon</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Cho, Sung Ryong" sort="Cho, Sung Ryong" uniqKey="Cho S" first="Sung Ryong" last="Cho">Sung Ryong Cho</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Jae Soo" sort="Kim, Jae Soo" uniqKey="Kim J" first="Jae Soo" last="Kim">Jae Soo Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Urology, Daegu Fatima Hospital, Daegu</wicri:regionArea><wicri:noRegion>Daegu</wicri:noRegion></affiliation></author></analytic><series><title level="j">Korean Journal of Urology</title><idno type="ISSN">2005-6737</idno><idno type="eISSN">2005-6745</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>In recent years, laser surgery has been widely used to treat benign prostatic hyperplasia (BPH). A thulium:yttrium-aluminium-garnet (Tm:YAG) laser was recently introduced for BPH surgery. We compared the effectiveness and safety of Tm:YAG laser vaporesection of the prostate (ThuVaRP) with that of bipolar transurethral resection of the prostate (TURP).</p></sec><sec><title>Materials and Methods</title><p>From January 2010 to December 2012, 86 patients underwent surgical treatment for symptomatic BPH by a single surgeon. We retrospectively analyzed and compared the medical records of 43 patients who underwent ThuVaRP and 43 patients who underwent bipolar TURP. All patients were assessed by using the International Prostate Symptom Score, transrectal ultrasonography, the serum prostate-specific antigen (PSA) level, uroflowmetry, and postvoid residual volume before and 1 month after surgery. All complications were compared between the two groups.</p></sec><sec><title>Results</title><p>ThuVaRP was superior to TURP in catheterization time (p<0.001) and length of hospital stay (p<0.001). However, operation time was longer with ThuVaRP than with TURP (p<0.001). In patients with a large prostate (>50 g), operation time was much longer with ThuVaRP. One month after surgery, the decrease in PSA was greater (p=0.045) with ThuVaRP than with TURP, and the increase in maximal urine flow rate was greater (p<0.001) with ThuVaRP than with TURP. The postoperative complication transient urinary incontinence was significantly different between the ThuVaRP group (nine cases, 20.9%) and the TURP group (two cases, 4.7%). Other complications were comparable between groups.</p></sec><sec><title>Conclusions</title><p>The effectiveness and safety of ThuVaRP and TURP were comparable. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Korean J Urol</journal-id><journal-id journal-id-type="iso-abbrev">Korean J Urol</journal-id><journal-id journal-id-type="publisher-id">KJU</journal-id><journal-title-group><journal-title>Korean Journal of Urology</journal-title></journal-title-group><issn pub-type="ppub">2005-6737</issn><issn pub-type="epub">2005-6745</issn><publisher><publisher-name>The Korean Urological Association</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24466396</article-id><article-id pub-id-type="pmc">3897629</article-id><article-id pub-id-type="doi">10.4111/kju.2014.55.1.41</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject><subj-group><subject>Lasers in Urology</subject></subj-group></subj-group></article-categories><title-group><article-title>An Analytical Comparison of Short-term Effectiveness and Safety Between Thulium:YAG Laser Vaporesection of the Prostate and Bipolar Transurethral Resection of the Prostate in Patients With Benign Prostatic Hyperplasia</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Joon Woo</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Yeon Joo</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Yoon Hyung</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Kwon</surname><given-names>Joon Beom</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Cho</surname><given-names>Sung Ryong</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Kim</surname><given-names>Jae Soo</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib></contrib-group><aff id="A1">Department of Urology, Daegu Fatima Hospital, Daegu, Korea.</aff><author-notes><corresp>Corresponding Author: Jae Soo Kim. Department of Urology, Daegu Fatima Hospital, 99 Ayang-ro, Dong-gu, Daegu 701-724, Korea. TEL: +82-53-940-7152, FAX: +82-53-954-7417, <email>mdkjs99@hanmail.net</email></corresp></author-notes><pub-date pub-type="ppub"><month>1</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>15</day><month>1</month><year>2014</year></pub-date><volume>55</volume><issue>1</issue><fpage>41</fpage><lpage>46</lpage><history><date date-type="received"><day>04</day><month>6</month><year>2013</year></date><date date-type="accepted"><day>02</day><month>10</month><year>2013</year></date></history><permissions><copyright-statement>© The Korean Urological Association, 2014</copyright-statement><copyright-year>2014</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Purpose</title><p>In recent years, laser surgery has been widely used to treat benign prostatic hyperplasia (BPH). A thulium:yttrium-aluminium-garnet (Tm:YAG) laser was recently introduced for BPH surgery. We compared the effectiveness and safety of Tm:YAG laser vaporesection of the prostate (ThuVaRP) with that of bipolar transurethral resection of the prostate (TURP).</p></sec><sec><title>Materials and Methods</title><p>From January 2010 to December 2012, 86 patients underwent surgical treatment for symptomatic BPH by a single surgeon. We retrospectively analyzed and compared the medical records of 43 patients who underwent ThuVaRP and 43 patients who underwent bipolar TURP. All patients were assessed by using the International Prostate Symptom Score, transrectal ultrasonography, the serum prostate-specific antigen (PSA) level, uroflowmetry, and postvoid residual volume before and 1 month after surgery. All complications were compared between the two groups.</p></sec><sec><title>Results</title><p>ThuVaRP was superior to TURP in catheterization time (p<0.001) and length of hospital stay (p<0.001). However, operation time was longer with ThuVaRP than with TURP (p<0.001). In patients with a large prostate (>50 g), operation time was much longer with ThuVaRP. One month after surgery, the decrease in PSA was greater (p=0.045) with ThuVaRP than with TURP, and the increase in maximal urine flow rate was greater (p<0.001) with ThuVaRP than with TURP. The postoperative complication transient urinary incontinence was significantly different between the ThuVaRP group (nine cases, 20.9%) and the TURP group (two cases, 4.7%). Other complications were comparable between groups.</p></sec><sec><title>Conclusions</title><p>The effectiveness and safety of ThuVaRP and TURP were comparable. ThuVaRP is a promising alternative surgical technique to TURP for BPH.</p></sec></abstract><kwd-group><kwd>Prostatic hyperplasia</kwd><kwd>Thulium</kwd><kwd>Transurethral resection of the prostate</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" orientation="portrait" position="float"><label>FIG. 1</label><caption><p>The mean operation time of the thulium laser vaporesection of the prostate. TRUS, transrectal ultrasound.</p></caption><graphic xlink:href="kju-55-41-g001"></graphic></fig><table-wrap id="T1" orientation="portrait" position="float"><label>TABLE 1</label><caption><p>Baseline characteristics</p></caption><graphic xlink:href="kju-55-41-i001"></graphic><table-wrap-foot><fn><p>Values are presented as mean±standard deviation.</p><p>ThuVaRP, thulium laser vaporesection of the prostate; TURP, transurethral resection of the prostate; IPSS, International Prostate Symptom Score; TRUS, transrectal ultrasound; vol., volume; PSA, prostate-specific antigen; Qmax, maximum flow rate; PVR, postvoid residual.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T2" orientation="portrait" position="float"><label>TABLE 2</label><caption><p>Perioperative data</p></caption><graphic xlink:href="kju-55-41-i002"></graphic><table-wrap-foot><fn><p>Values are presented as mean±standard deviation.</p><p>ThuVaRP, thulium laser vaporesection of the prostate; TURP, transurethral resection of the prostate.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T3" orientation="portrait" position="float"><label>TABLE 3</label><caption><p>Changes in clinical parameters after ThuVaRP</p></caption><graphic xlink:href="kju-55-41-i003"></graphic><table-wrap-foot><fn><p>Values are presented as mean±standard deviation.</p><p>ThuVaRP, thulium laser vaporesection of the prostate; IPSS, International Prostate Symptom Score; TRUS, transrectal ultrasound; vol., volume; PSA, prostate-specfic antigen; Qmax, maximum flow rate; PVR, postvoid residual.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T4" orientation="portrait" position="float"><label>TABLE 4</label><caption><p>Changes in clinical parameters after TURP</p></caption><graphic xlink:href="kju-55-41-i004"></graphic><table-wrap-foot><fn><p>Values are presented as mean±standard deviation.</p><p> TURP, transurethral resection of the prostate; IPSS, International Prostate Symptom Score; TRUS, transrectal ultrasound; vol., volume; PSA, prostate-specfic antigen; Qmax, maximum flow rate; PVR, postvoid residual.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T5" orientation="portrait" position="float"><label>TABLE 5</label><caption><p>Comparison of perioperative data between ThuVaRP and TURP</p></caption><graphic xlink:href="kju-55-41-i005"></graphic><table-wrap-foot><fn><p>Values are presented as mean±standard deviation.</p><p>ThuVaRP, thulium laser vaporesection of the prostate; TURP, transurethral resection of the prostate; IPSS, International Prostate Symptom Score; TRUS, transrectal ultrasound; vol., volume; PSA, prostate-specfic antigen; Qmax, maximum flow rate; PVR, postvoid residual.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T6" orientation="portrait" position="float"><label>TABLE 6</label><caption><p>Postoperative complications</p></caption><graphic xlink:href="kju-55-41-i006"></graphic><table-wrap-foot><fn><p>Values are presented as no. of cases (%).</p><p>ThuVaRP, thulium laser vaporesection of the prostate; TURP, transurethral resection of the prostate.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Kim, Joon Woo" sort="Kim, Joon Woo" uniqKey="Kim J" first="Joon Woo" last="Kim">Joon Woo Kim</name></noRegion><name sortKey="Cho, Sung Ryong" sort="Cho, Sung Ryong" uniqKey="Cho S" first="Sung Ryong" last="Cho">Sung Ryong Cho</name><name sortKey="Kim, Jae Soo" sort="Kim, Jae Soo" uniqKey="Kim J" first="Jae Soo" last="Kim">Jae Soo Kim</name><name sortKey="Kim, Yeon Joo" sort="Kim, Yeon Joo" uniqKey="Kim Y" first="Yeon Joo" last="Kim">Yeon Joo Kim</name><name sortKey="Kwon, Joon Beom" sort="Kwon, Joon Beom" uniqKey="Kwon J" first="Joon Beom" last="Kwon">Joon Beom Kwon</name><name sortKey="Lee, Yoon Hyung" sort="Lee, Yoon Hyung" uniqKey="Lee Y" first="Yoon Hyung" last="Lee">Yoon Hyung Lee</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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