Feasibility and efficacy of Thulium:YAG laser enucleation (VapoEnucleation) of the prostate View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-08

AUTHORS

T. Bach, G. Wendt-Nordahl, M. S. Michel, T. R. W. Herrmann, A. J. Gross

ABSTRACT

PURPOSE: Thulium:YAG (Tm:YAG) vaporesection has been introduced and efficiency was shown on smaller prostates. Criticism mainly referred to prolonged operation time in larger prostates, which appears to be a potential limitation compared to HoLEP. Aim of the study was to evaluate feasibility and efficiency of Tm:YAG VapoEnucleation in larger prostates. METHODS: VapoEnucleation was performed using a 70 W continuous wave-laser. After enucleation tissue was morcellated within the bladder. Prospectively assessed outcomes were improvement in urodynamic parameter and the intra- and postoperative course. Complications were recorded. RESULTS: A total of 88 consecutive patients with prostatic enlargement underwent VapoEnucleation. Prostatic volume was 61.3 +/- 24.0 cc (30-160). OR-time was 72 min +/- 26.6 (35-144) and laser-time 32.4 +/- 10.1 min (16.3-59.3). Applied laser energy was 123.7 +/- 40.6 kJ (67.8-240.9). An average of 31.7 +/- 18.3 g of tissue was retrieved. Pathology revealed four patients with incidental carcinoma. Foley catheter-time was 2 days and the suprapubic tube, if placed, was removed on the third postoperative day on average. Twelve complications were recorded, including bleeding (3), urinary tract infection (6), second-look procedure, due to insufficient deobstruction (2). Re-catherization after successful initial voiding trial was necessary in one patient. Mean peak flow rate improved from 3.5 +/- 4.7 to 19.8 +/- 11.6 ml/s and post-voiding residual urine decreased from 121.4 +/- 339.9 to 22.4 +/- 32.7 ml. CONCLUSION: The functional outcomes demonstrate efficiency of Tm:YAG VapoEnucleation for patients with larger prostates. From our experience, learning curve in VapoEnucleation is short and complications are minimal. Theoretically, no limitation in prostate size occurs. Long-term follow-up is needed to prove durability. More... »

PAGES

541

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-008-0370-0

DOI

http://dx.doi.org/10.1007/s00345-008-0370-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1035592937

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19184038


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