Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients
Identifieur interne : 000255 ( Pmc/Curation ); précédent : 000254; suivant : 000256Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients
Auteurs : Fabrizio Iacono [Italie] ; Domenico Prezioso [Italie] ; Giovanni Di Lauro [Italie] ; Giuseppe Romeo [Italie] ; Antonio Ruffo [Italie] ; Ester Illiano [Italie] ; Bruno Amato [Italie]Source :
- BMC Surgery [ 1471-2482 ] ; 2012.
Abstract
Over the past years laser technology has played a predominant role in prostate surgery, for the treatment of benign prostate hypertrophy (BPH). Various laser devices have been introduced in clinical practice, showing good results in terms of complications and urodynamic outcomes efficacy compared with TURP and Open Prostatectomy.
In this study we describe the efficacy and the safety profile of a novel laser technique, ThuLEP (Thulium Laser Enucleation of Prostate) that permits a complete anatomical endoscopic enucleation of prostatic adenoma independently to prostate size.
148 patients with a mean age of 68.2 years were enrolled between September 2009 and March 2012 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), International Index of Erectile Function-5 (IIEF-5), Quality of Life (QoL), PSA values, urine analysis and urine culture, uroflowmetry. The same evaluation was conducted after a 12 month follow-up. ThuLEP was performed by 2 expert surgeons.
Our data showed a better post-operative outcome in terms of catheter removal, blood loss, TURP syndrome, clot retention and residual tissue compared to large series of TURP and OP. Only 1.3% of patients had bladder wall injury during morcellation. I-PSS, Qmax, Prostate Volume, QoL and PVR showed a highly significant improvement at 12 month follow-up in comparison to preoperative assessment.
ThuLEP represent an innovative option in patients with BPH. It is a size independent surgical endoscopic technique and it can be considered the real alternative, at this time, to TURP and even more to Open Prostatectomy for large prostate, with a complete removal of adenoma and with a low complication rate.
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DOI: 10.1186/1471-2482-12-S1-S21
PubMed: 23173611
PubMed Central: 3499280
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients</title><author><name sortKey="Iacono, Fabrizio" sort="Iacono, Fabrizio" uniqKey="Iacono F" first="Fabrizio" last="Iacono">Fabrizio Iacono</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Prezioso, Domenico" sort="Prezioso, Domenico" uniqKey="Prezioso D" first="Domenico" last="Prezioso">Domenico Prezioso</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Di Lauro, Giovanni" sort="Di Lauro, Giovanni" uniqKey="Di Lauro G" first="Giovanni" last="Di Lauro">Giovanni Di Lauro</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Urology, Hospital S.Maria delle Grazie of Pozzuoli (Na), Via Domiziana – 80078 – Pozzuoli (Na), Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, Hospital S.Maria delle Grazie of Pozzuoli (Na), Via Domiziana – 80078 – Pozzuoli (Na)</wicri:regionArea></affiliation></author><author><name sortKey="Romeo, Giuseppe" sort="Romeo, Giuseppe" uniqKey="Romeo G" first="Giuseppe" last="Romeo">Giuseppe Romeo</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Ruffo, Antonio" sort="Ruffo, Antonio" uniqKey="Ruffo A" first="Antonio" last="Ruffo">Antonio Ruffo</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Illiano, Ester" sort="Illiano, Ester" uniqKey="Illiano E" first="Ester" last="Illiano">Ester Illiano</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Amato, Bruno" sort="Amato, Bruno" uniqKey="Amato B" first="Bruno" last="Amato">Bruno Amato</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of General, Geriatric, Oncological Surgery and Advanced Technologies, University “Federico II” of Naples. Via Pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of General, Geriatric, Oncological Surgery and Advanced Technologies, University “Federico II” of Naples. Via Pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23173611</idno><idno type="pmc">3499280</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499280</idno><idno type="RBID">PMC:3499280</idno><idno type="doi">10.1186/1471-2482-12-S1-S21</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">000255</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000255</idno><idno type="wicri:Area/Pmc/Curation">000255</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000255</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients</title><author><name sortKey="Iacono, Fabrizio" sort="Iacono, Fabrizio" uniqKey="Iacono F" first="Fabrizio" last="Iacono">Fabrizio Iacono</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Prezioso, Domenico" sort="Prezioso, Domenico" uniqKey="Prezioso D" first="Domenico" last="Prezioso">Domenico Prezioso</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Di Lauro, Giovanni" sort="Di Lauro, Giovanni" uniqKey="Di Lauro G" first="Giovanni" last="Di Lauro">Giovanni Di Lauro</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Urology, Hospital S.Maria delle Grazie of Pozzuoli (Na), Via Domiziana – 80078 – Pozzuoli (Na), Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, Hospital S.Maria delle Grazie of Pozzuoli (Na), Via Domiziana – 80078 – Pozzuoli (Na)</wicri:regionArea></affiliation></author><author><name sortKey="Romeo, Giuseppe" sort="Romeo, Giuseppe" uniqKey="Romeo G" first="Giuseppe" last="Romeo">Giuseppe Romeo</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Ruffo, Antonio" sort="Ruffo, Antonio" uniqKey="Ruffo A" first="Antonio" last="Ruffo">Antonio Ruffo</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Illiano, Ester" sort="Illiano, Ester" uniqKey="Illiano E" first="Ester" last="Illiano">Ester Illiano</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author><author><name sortKey="Amato, Bruno" sort="Amato, Bruno" uniqKey="Amato B" first="Bruno" last="Amato">Bruno Amato</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of General, Geriatric, Oncological Surgery and Advanced Technologies, University “Federico II” of Naples. Via Pasini, 5 – 80131 – Naples, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of General, Geriatric, Oncological Surgery and Advanced Technologies, University “Federico II” of Naples. Via Pasini, 5 – 80131 – Naples</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Surgery</title><idno type="eISSN">1471-2482</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Over the past years laser technology has played a predominant role in prostate surgery, for the treatment of benign prostate hypertrophy (BPH). Various laser devices have been introduced in clinical practice, showing good results in terms of complications and urodynamic outcomes efficacy compared with TURP and Open Prostatectomy.</p><p>In this study we describe the efficacy and the safety profile of a novel laser technique, ThuLEP (Thulium Laser Enucleation of Prostate) that permits a complete anatomical endoscopic enucleation of prostatic adenoma independently to prostate size.</p></sec><sec><title>Methods</title><p>148 patients with a mean age of 68.2 years were enrolled between September 2009 and March 2012 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), International Index of Erectile Function-5 (IIEF-5), Quality of Life (QoL), PSA values, urine analysis and urine culture, uroflowmetry. The same evaluation was conducted after a 12 month follow-up. ThuLEP was performed by 2 expert surgeons.</p></sec><sec><title>Results</title><p>Our data showed a better post-operative outcome in terms of catheter removal, blood loss, TURP syndrome, clot retention and residual tissue compared to large series of TURP and OP. Only 1.3% of patients had bladder wall injury during morcellation. I-PSS, Qmax, Prostate Volume, QoL and PVR showed a highly significant improvement at 12 month follow-up in comparison to preoperative assessment.</p></sec><sec><title>Conclusion</title><p>ThuLEP represent an innovative option in patients with BPH. It is a size independent surgical endoscopic technique and it can be considered the real alternative, at this time, to TURP and even more to Open Prostatectomy for large prostate, with a complete removal of adenoma and with a low complication rate.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kuntz, Rm" uniqKey="Kuntz R">RM Kuntz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ahyai, Sa" uniqKey="Ahyai S">SA Ahyai</name></author><author><name sortKey="Gilling, P" uniqKey="Gilling P">P Gilling</name></author><author><name sortKey="Kaplan, Sa" uniqKey="Kaplan S">SA Kaplan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shanberg, Am" uniqKey="Shanberg A">AM Shanberg</name></author><author><name sortKey="Lee, Is" uniqKey="Lee I">IS Lee</name></author><author><name sortKey="Tansey, La" uniqKey="Tansey L">LA 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Tr" uniqKey="Herrmann T">TR Herrmann</name></author><author><name sortKey="Cellarius, C" uniqKey="Cellarius C">C Cellarius</name></author><author><name sortKey="Gross, Aj" uniqKey="Gross A">AJ Gross</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Xia, Sj" uniqKey="Xia S">SJ Xia</name></author><author><name sortKey="Zhuo, J" uniqKey="Zhuo J">J Zhuo</name></author><author><name sortKey="Sun, Xw" uniqKey="Sun X">XW Sun</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fu, Wj" uniqKey="Fu W">WJ Fu</name></author><author><name sortKey="Zhang, X" uniqKey="Zhang X">X Zhang</name></author><author><name sortKey="Yang, Y" uniqKey="Yang Y">Y Yang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcconnel, Jd" uniqKey="Mcconnel J">JD McConnel</name></author><author><name sortKey="Barry, Mj" uniqKey="Barry M">MJ Barry</name></author><author><name sortKey="Bruskewitz, Rc" uniqKey="Bruskewitz R">RC 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Surg</journal-id><journal-id journal-id-type="iso-abbrev">BMC Surg</journal-id><journal-title-group><journal-title>BMC Surgery</journal-title></journal-title-group><issn pub-type="epub">1471-2482</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23173611</article-id><article-id pub-id-type="pmc">3499280</article-id><article-id pub-id-type="publisher-id">1471-2482-12-S1-S21</article-id><article-id pub-id-type="doi">10.1186/1471-2482-12-S1-S21</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Iacono</surname><given-names>Fabrizio</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>fiacon@tin.it</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Prezioso</surname><given-names>Domenico</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>dprezioso@libero.it</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Di Lauro</surname><given-names>Giovanni</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>giovanni.dilauro2@tin.it</email></contrib><contrib contrib-type="author" id="A4"><name><surname>Romeo</surname><given-names>Giuseppe</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>giuseppe.romeo85@gmail.com</email></contrib><contrib contrib-type="author" id="A5"><name><surname>Ruffo</surname><given-names>Antonio</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>antonio.ruffo7@gmail.com</email></contrib><contrib contrib-type="author" id="A6"><name><surname>Illiano</surname><given-names>Ester</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>ester.illiano@inwind.it</email></contrib><contrib contrib-type="author" id="A7"><name><surname>Amato</surname><given-names>Bruno</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>bruno.amato@unina.it</email></contrib></contrib-group><aff id="I1"><label>1</label>Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy</aff><aff id="I2"><label>2</label>Department of Urology, Hospital S.Maria delle Grazie of Pozzuoli (Na), Via Domiziana – 80078 – Pozzuoli (Na), Italy</aff><aff id="I3"><label>3</label>Department of General, Geriatric, Oncological Surgery and Advanced Technologies, University “Federico II” of Naples. Via Pasini, 5 – 80131 – Naples, Italy</aff><pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="epub"><day>15</day><month>11</month><year>2012</year></pub-date><volume>12</volume><issue>Suppl 1</issue><supplement><named-content content-type="supplement-title">Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery</named-content><named-content content-type="supplement-editor">Silvestro Canonico, Bruno Amato and Beatrice Sensi</named-content><named-content content-type="supplement-sponsor">This supplement has not been supported by sponsorship or other external funding.</named-content></supplement><fpage>S21</fpage><lpage>S21</lpage><permissions><copyright-statement>Copyright ©2012 Iacono et al; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2012</copyright-year><copyright-holder>Iacono et al; licensee BioMed Central Ltd.</copyright-holder><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 (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://www.biomedcentral.com/1471-2482/12/S1/S21"></self-uri><abstract><sec><title>Background</title><p>Over the past years laser technology has played a predominant role in prostate surgery, for the treatment of benign prostate hypertrophy (BPH). Various laser devices have been introduced in clinical practice, showing good results in terms of complications and urodynamic outcomes efficacy compared with TURP and Open Prostatectomy.</p><p>In this study we describe the efficacy and the safety profile of a novel laser technique, ThuLEP (Thulium Laser Enucleation of Prostate) that permits a complete anatomical endoscopic enucleation of prostatic adenoma independently to prostate size.</p></sec><sec><title>Methods</title><p>148 patients with a mean age of 68.2 years were enrolled between September 2009 and March 2012 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), International Index of Erectile Function-5 (IIEF-5), Quality of Life (QoL), PSA values, urine analysis and urine culture, uroflowmetry. The same evaluation was conducted after a 12 month follow-up. ThuLEP was performed by 2 expert surgeons.</p></sec><sec><title>Results</title><p>Our data showed a better post-operative outcome in terms of catheter removal, blood loss, TURP syndrome, clot retention and residual tissue compared to large series of TURP and OP. Only 1.3% of patients had bladder wall injury during morcellation. I-PSS, Qmax, Prostate Volume, QoL and PVR showed a highly significant improvement at 12 month follow-up in comparison to preoperative assessment.</p></sec><sec><title>Conclusion</title><p>ThuLEP represent an innovative option in patients with BPH. It is a size independent surgical endoscopic technique and it can be considered the real alternative, at this time, to TURP and even more to Open Prostatectomy for large prostate, with a complete removal of adenoma and with a low complication rate.</p></sec></abstract><conference><conf-date>10-11 May 2012</conf-date><conf-name>XXV National Congress of the Italian Society of Geriatric Surgery</conf-name><conf-loc>Padova, Italy</conf-loc></conference></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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