Thulium Laser Enucleation Versus Plasmakinetic Resection of the Prostate: A Randomized Prospective Trial With 18-Month Follow-up

Yang, Zhonghua; Wang, Xinghuan; Liu, Tongzu

doi:10.1016/j.urology.2012.08.069

Cited by 65 publications

(38 citation statements)

References 20 publications

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“…In this series, voiding parameters (Qmax, PVR) and symptom scores (IPSS, QoL) were significantly improved after ThuVEP and ThuVaRP at 12- and 24-month follow-up, in line with the current HoLEP [2, 3, 7], PVP [2, 3], and TURP [2-4, 6, 9, 11, 15, 22, 23] literature and well-comparable to former ThuVEP [7, 8, 17, 18] and ThuVaRP [4, 6, 9-14, 22, 24-26] series. However, at 24-month follow-up, Qmax and PVR were significantly different between ThuVEP and ThuVaRP, while no differences were found between the groups with regard to IPSS and QoL.…”

Section: Discussionsupporting

confidence: 61%

“…Due to the retrospective non-randomized approach, a selection bias based on primary detrusor failure due to long-lasting BPO in the ThuVEP group cannot be excluded completely, since pressure flow studies have not been performed preoperatively. Although significant differences in Qmax and PVR were found in our study, the clinical relevance is questionable, since the Qmax and PVR values in our series at 12- and 24-month follow-up after ThuVEP are well comparable with the TURP [2-4, 6, 9, 11, 15, 22, 23], HoLEP [2, 3], PVP [2, 3], ThuVaRP [4, 6, 9-14, 22, 24-26] and ThuVEP [7, 8, 17, 18] literature.…”

Section: Discussionmentioning

confidence: 59%

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Thulium Vaporesection of the Prostate and Thulium Vapoenucleation of the Prostate: A Retrospective Bicentric Matched-Paired Comparison with 24-Month Follow-Up

et al. 2017

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Introduction: To evaluate the intermediate-term outcomes of thulium vapoenucleation of the prostate (ThuVEP) and thulium vaporesection of the prostate (ThuVaRP) in patients with benign prostate obstruction (BPO). Materials and Methods: A bicentric retrospective matched-paired comparison of patients treated by ThuVEP (n = 80) or ThuVaRP (n = 80) was performed. The patients were preoperatively assessed with International Prostate Symptom Score (IPSS), quality of life (QoL), post-void residual urine (PVR), maximum urinary flow rate (Qmax), prostatespecific antigen (PSA) and re-evaluated at 12- and 24-month follow-up. Results: Median prostate volume was 65 mL and not different between the groups. The immediate re-operation rate was significantly different between ThuVEP and ThuVaRP (5 vs. 0%, p ≤ 0.0434). IPSS, QoL, Qmax and PVR had improved significantly compared to preoperative assessment in both groups at 12- and 24-month follow-up (p ≤ 0.001). Median Qmax (18.2 vs. 21.0 mL/s) and PVR (29.4 vs. 0 mL) were significantly different between ThuVEP and ThuVaRP at 24-month follow-up (p ≤ 0.001), while IPSS and QoL showed no differences between the groups. However, the PSA reduction was significantly higher after ThuVEP compared to ThuVaRP (78.93 vs. 23.39%, p ≤ 0.006) at 24-month follow-up. Conclusions: ThuVEP and ThuVaRP are safe and efficacious procedures for patients with BPO. Although the peri-operative re-intervention rates were lower after ThuVaRP, the low PSA reduction rate after ThuVaRP at 24-month follow-up favours the ThuVEP procedure.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 59%

Thulium Vaporesection of the Prostate and Thulium Vapoenucleation of the Prostate: A Retrospective Bicentric Matched-Paired Comparison with 24-Month Follow-Up

et al. 2017

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“…The authors found that ThuLEP required a significantly longer operative time (65.4 versus 47.4 minutes, p = 0.022) than BiTURP, but resulted in a significantly shorter hospital stay (2.4 versus 4.6 days, p = 0.026), shorter catheterization time (2.1 versus 3.5 days, p = 0.031) and lower drop in hemoglobin (0.15 versus 0.30 g/dl). Similar improvements were seen in IPSS, QoL, Qmax and PVR [Yang et al 2013]. Short-term and perioperative complications were not mentioned.…”

Section: Comparative Studies To Bipolar Transurethral Plasmakinetic Psupporting

confidence: 55%

Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction

Barbalat

Velez

Sayegh

et al. 2016

Therapeutic Advances in Urology

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In 2005, the high power thulium laser was introduced for the surgical treatment of benign prostatic obstruction. It has several properties that confer theoretical advantages over other lasers used for the same indication, such as technical versatility and a relatively small zone of thermal damage. Studies using the 70-150 W thulium laser systems demonstrate good efficacy of these procedures with low morbidity and few complications even in higher risk patients. Different techniques have been employed to treat the prostate with this technology, including enucleation, vapoenucleation, vaporization and resection. Comparative studies have been published comparing thulium laser prostatectomy to monopolar transurethral resection of prostate (TURP), bipolar TURP and holmium laser enucleation of prostate (HoLEP). In this review we discuss the current literature on the safety and efficacy of various thulium techniques for the treatment of benign prostatic hyperplasia and examine comparative studies.

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“…2 In a very recent randomized prospective trial comparing the outcomes of thulium laser enucleation and PKR, the authors reported a mean operation time of 47.4 minutes and a mean hemoglobin drop of 0.30 g/dL in patients who underwent PKR. 12 In our study in the PKR group, the mean hemoglobin drop and the mean operation time was 1.28 ± 0.75 g/dL and 52.07 ± 8.682 minutes. There was a similarity between the results of our study and the results by Kang and colleagues 12 in terms of operation time, but the mean hemoglobin drop in patients who underwent PKR in our study was higher than the drop in the other study.…”

Section: Discussionmentioning

confidence: 50%

“…12 In our study in the PKR group, the mean hemoglobin drop and the mean operation time was 1.28 ± 0.75 g/dL and 52.07 ± 8.682 minutes. There was a similarity between the results of our study and the results by Kang and colleagues 12 in terms of operation time, but the mean hemoglobin drop in patients who underwent PKR in our study was higher than the drop in the other study. This study's hemoglobin drop was similar to our PKVP group.…”

Section: Discussionmentioning

confidence: 50%

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

Karadağ

Çeçen

Demir

et al. 2014

CUAJ

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Introduction: We evaluate the efficacy and outcomes of plasmakinetic vaporization (PKVP) and plasmakinetic resection (PKR) to treat benign prostatic hyperplasia (BPH).Methods: A total of 183 patients with BPH underwent plasmakinetic prostatic surgery between 2008 and 2012 at Kars State Hospital and Kafkas University Faculty of Medicine, Turkey. After clinical and preoperative evaluation, the patients were randomized to PKRP or PKVP groups sequentially by using computer-generated numbers. Group 1 included 96 patients treated with PKR. Group 2 included 87 patients treated with PKVP. Patients in both groups were compared in terms of hemoglobin drop, operation time, catheter duration, reobstruction, incontinence and recatheterization.Results: When we compared the maximum flow rates (Qmax values) at the 12th month, there was no statistical difference between 2 groups. Group 1 had a mean Qmax value of 17.92 ± 3.819 and Group 2 had a 18.15 ± 3.832 value (p > 0.05). There was a statistical difference between the groups in terms of hemoglobin drop, catheter duration and operation time. The mean catheter duration in Group 1 was 3.74 ± 1.049 days, and in Group 2 it was 2.64 ± 0.849 days (p < 0.05). Operation time was statistically longer in Group 2 (PKVP) and hemoglobin drop was statistically higher in Group 1 (PKR).Conclusion: PKVP for BPH is safe and effective. When compared with PKRP, it provides a significantly shorter catheter duration and less bleeding due to hemostasis control with similar IPSS and Qmax improvements after 1 year.

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Thulium Laser Enucleation Versus Plasmakinetic Resection of the Prostate: A Randomized Prospective Trial With 18-Month Follow-up

Cited by 65 publications

References 20 publications

Thulium Vaporesection of the Prostate and Thulium Vapoenucleation of the Prostate: A Retrospective Bicentric Matched-Paired Comparison with 24-Month Follow-Up

Thulium Vaporesection of the Prostate and Thulium Vapoenucleation of the Prostate: A Retrospective Bicentric Matched-Paired Comparison with 24-Month Follow-Up

Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction

Plasmakinetic vaporization versus plasmakinetic resection to treat benign prostatic hyperplasia: A prospective randomized trial with 1 year follow-up

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