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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Thulium laser versus standard transurethral resection of the prostate: A randomized prospective trial</title><author><name sortKey="Dubey, Deepak" sort="Dubey, Deepak" uniqKey="Dubey D" first="Deepak" last="Dubey">Deepak Dubey</name><affiliation><nlm:aff id="AF0001">Department of Urology, SGPGI, Lucknow, India</nlm:aff></affiliation></author><author><name sortKey="Muruganandham, K" sort="Muruganandham, K" uniqKey="Muruganandham K" first="K." last="Muruganandham">K. Muruganandham</name><affiliation><nlm:aff id="AF0001">Department of Urology, SGPGI, Lucknow, India</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19468488</idno><idno type="pmc">2684372</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684372</idno><idno type="RBID">PMC:2684372</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000210</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000210</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Thulium laser versus standard transurethral resection of the prostate: A randomized prospective trial</title><author><name sortKey="Dubey, Deepak" sort="Dubey, Deepak" uniqKey="Dubey D" first="Deepak" last="Dubey">Deepak Dubey</name><affiliation><nlm:aff id="AF0001">Department of Urology, SGPGI, Lucknow, India</nlm:aff></affiliation></author><author><name sortKey="Muruganandham, K" sort="Muruganandham, K" uniqKey="Muruganandham K" first="K." last="Muruganandham">K. Muruganandham</name><affiliation><nlm:aff id="AF0001">Department of Urology, SGPGI, Lucknow, India</nlm:aff></affiliation></author></analytic><series><title level="j">Indian Journal of Urology : IJU : Journal of the Urological Society of India</title><idno type="ISSN">0970-1591</idno><idno type="eISSN">1998-3824</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tan, Ah" uniqKey="Tan A">AH Tan</name></author><author><name sortKey="Gilling, Pj" uniqKey="Gilling P">PJ Gilling</name></author><author><name sortKey="Kennett, Km" uniqKey="Kennett K">KM Kennett</name></author><author><name sortKey="Frampton, C" uniqKey="Frampton C">C Frampton</name></author><author><name sortKey="Westenberg, Am" uniqKey="Westenberg A">AM Westenberg</name></author><author><name sortKey="Fraundorfer, Mr" uniqKey="Fraundorfer M">MR Fraundorfer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuntz, Rm" uniqKey="Kuntz R">RM Kuntz</name></author><author><name sortKey="Lehrich, K" uniqKey="Lehrich K">K Lehrich</name></author><author><name sortKey="Ahyai, Sa" uniqKey="Ahyai S">SA Ahyai</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bachmann, A" uniqKey="Bachmann A">A Bachmann</name></author><author><name sortKey="Schurch, L" uniqKey="Schurch L">L Schürch</name></author><author><name sortKey="Ruszat, R" uniqKey="Ruszat R">R Ruszat</name></author><author><name sortKey="Wyler, Sf" uniqKey="Wyler S">SF Wyler</name></author><author><name sortKey="Seifert, Hh" uniqKey="Seifert H">HH Seifert</name></author><author><name sortKey="Muller, A" uniqKey="Muller A">A Müller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alivizatos, G" uniqKey="Alivizatos G">G Alivizatos</name></author><author><name sortKey="Skolarikos, A" uniqKey="Skolarikos A">A Skolarikos</name></author><author><name sortKey="Chalikopoulos, D" uniqKey="Chalikopoulos D">D Chalikopoulos</name></author><author><name sortKey="Papachristou, C" uniqKey="Papachristou C">C Papachristou</name></author><author><name sortKey="Sopilidis, O" uniqKey="Sopilidis O">O Sopilidis</name></author><author><name sortKey="Dellis, A" uniqKey="Dellis A">A Dellis</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="other"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Urol</journal-id><journal-id journal-id-type="publisher-id">IJU</journal-id><journal-title-group><journal-title>Indian Journal of Urology : IJU : Journal of the Urological Society of India</journal-title></journal-title-group><issn pub-type="ppub">0970-1591</issn><issn pub-type="epub">1998-3824</issn><publisher><publisher-name>Medknow Publications</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19468488</article-id><article-id pub-id-type="pmc">2684372</article-id><article-id pub-id-type="publisher-id">IJU-24-428</article-id><article-categories><subj-group subj-group-type="heading"><subject>Uroscan</subject></subj-group></article-categories><title-group><article-title>Thulium laser versus standard transurethral resection of the prostate: A randomized prospective trial</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Dubey</surname><given-names>Deepak</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author"><name><surname>Muruganandham</surname><given-names>K.</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><aff id="AF0001">Department of Urology, SGPGI, Lucknow, India</aff></contrib-group><author-notes><fn fn-type="other"><p><bold>Xia SJ, Zhuo J, Sun XW, Han BM, Shao Y, Zhang YN. Thulium laser versus standard transurethral resection of the prostate: A randomized prospective trial. Eur Urol 2008;53:382-90.</bold></p></fn></author-notes><pub-date pub-type="ppub"><season>Jul-Sep</season><year>2008</year></pub-date><volume>24</volume><issue>3</issue><fpage>428</fpage><lpage>429</lpage><permissions><copyright-statement>© Indian Journal of Urology</copyright-statement><copyright-year>2008</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions></article-meta></front><body><sec id="sec1-1"><title>SUMMARY</title><p>In this prospective trial the authors randomized 100 consecutive patients to receive either a TURP (n = 48) or Thulium Laser Prostatectomy (n = 52). All patients were preoperatively assessed with subjective symptoms score, International Index of Erectile Function questionnaire, and complete urodynamic evaluation. Preoperative and perioperative parameters at 1-, 6-, and 12-months follow-up were also evaluated. All complications were recorded. TmLRP-TT was significantly superior to TURP in terms of catheterization time (45.7 ± 25.8 h vs. 87.4 ± 33.8 h, <italic>P</italic> < 0.0001), hospital stay (115.1 ± 25.5 h vs. 161.1 ± 33.8 h, <italic>P</italic> < 0.0001), and drop in hemoglobin (0.92 ± 0.82 g/dl vs. 1.46 ± 0.65 g/dl, <italic>P</italic> < 0.001), whereas it required equivalent time to perform (46.3 ± 16.2 vs. 50.4 ± 20.7 min, <italic>P</italic> > 0.05). TmLRP-TT and TURP resulted in a significant improvement from baseline in terms of subjective symptoms scoring and urodynamic finding, but no significant difference was found between the two groups. Late complications were also comparable. TmLRP-TT is an almost bloodless procedure with high efficacy and little perioperative morbidity. TmLRP-TT is superior to TURP in safety and is as efficacious as TURP in one-year follow-up. It is a promising technology in the clinical practice field.</p></sec><sec sec-type="" id="sec1-2"><title>COMMENTS</title><sec id="sec2-1"><title>Is TURP out?</title><p>The advent of modern laser technology continues to offer a serious threat to the current gold standards for treating BPH, viz. TURP/Open prostatectomy. In a randomized trial comparing TURP with HoLEP, Tan <italic>et al</italic>.[<xref ref-type="bibr" rid="CIT1">1</xref>] demonstrated that HoLEP is superior to TURP in improving urodynamic bladder obstruction along with shorter catheterization time and decreased blood loss. In a recent randomized trial,[<xref ref-type="bibr" rid="CIT2">2</xref>] HoLEP showed better outcomes as compared to open prostatectomy for adenomas larger than 100 g over a long-term follow-up of five years. However, the learning curve for HoLEP is steep, which has prevented many urologists from accepting this technique. KTP green light laser has also demonstrated equivalence to TURP in a prospective clinical trial,[<xref ref-type="bibr" rid="CIT3">3</xref>] albeit with a follow-up of only six months. Similarly KTP laser prostatectomy has been found to be equally effective and safe as compared to open transvesical prostatectomy in a randomized prospective trial.[<xref ref-type="bibr" rid="CIT4">4</xref>]</p><p>In this statistically well-powered randomized prospective trial the authors have compared Thulium laser prostatectomy (ThLRP) to TURP. Over a follow-up of 12 months, they reported equal efficacy of the two techniques and decreased catheterization time, blood loss and hospital stay in favor of the Thulium laser. Unlike KTP, ThLRP retrieves prostatic tissue for biopsy, has a shorter learning curve than HoLEP. The operative technique most closely resembles TURP as compared to other lasers. Before this technique becomes widely accepted, we await experience from other centers with longer follow-up. However, it is becoming increasingly evident that TURP is facing genuine competition and might be replaced as the gold standard in minimally invasive surgery of the prostate.</p></sec></sec></body><back><ref-list><title>REFERENCES</title><ref id="CIT1"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tan</surname><given-names>AH</given-names></name><name><surname>Gilling</surname><given-names>PJ</given-names></name><name><surname>Kennett</surname><given-names>KM</given-names></name><name><surname>Frampton</surname><given-names>C</given-names></name><name><surname>Westenberg</surname><given-names>AM</given-names></name><name><surname>Fraundorfer</surname><given-names>MR</given-names></name></person-group><article-title>A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams)</article-title><source>J Urol</source><year>2003</year><volume>170</volume><fpage>1270</fpage><lpage>4</lpage><pub-id pub-id-type="pmid">14501739</pub-id></element-citation></ref><ref id="CIT2"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kuntz</surname><given-names>RM</given-names></name><name><surname>Lehrich</surname><given-names>K</given-names></name><name><surname>Ahyai</surname><given-names>SA</given-names></name></person-group><article-title>Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial</article-title><source>Eur Urol</source><year>2008</year><volume>53</volume><fpage>160</fpage><lpage>6</lpage><pub-id pub-id-type="pmid">17869409</pub-id></element-citation></ref><ref id="CIT3"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bachmann</surname><given-names>A</given-names></name><name><surname>Schürch</surname><given-names>L</given-names></name><name><surname>Ruszat</surname><given-names>R</given-names></name><name><surname>Wyler</surname><given-names>SF</given-names></name><name><surname>Seifert</surname><given-names>HH</given-names></name><name><surname>Müller</surname><given-names>A</given-names></name><etal></etal></person-group><article-title>Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): A prospective bi-centre study of perioperative morbidity and early functional outcome</article-title><source>Eur Urol</source><year>2005</year><volume>48</volume><fpage>965</fpage><lpage>72</lpage><pub-id pub-id-type="pmid">16126327</pub-id></element-citation></ref><ref id="CIT4"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Alivizatos</surname><given-names>G</given-names></name><name><surname>Skolarikos</surname><given-names>A</given-names></name><name><surname>Chalikopoulos</surname><given-names>D</given-names></name><name><surname>Papachristou</surname><given-names>C</given-names></name><name><surname>Sopilidis</surname><given-names>O</given-names></name><name><surname>Dellis</surname><given-names>A</given-names></name><etal></etal></person-group><article-title>Transurethral photoselective vaporization versus transvesical open enucleation for prostatic adenomas >80 ml: 12-mo results of a randomized prospective study</article-title><source>Eur Urol</source><year>2009</year><month>11</month><day>29</day><comment>[Epub ahead of print]</comment></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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