Early outcomes of transurethral thulium laser vapoenucleation of prostate

Abstract

Introduction. Surgical treatment of large benign prostatic hyperplasia (BPH) remain an important problem in endourology. Open surgical procedures are still used to treat pacients with BPH. Surgical trauma and numerous contraindications make it useless in many pacients with comorbydities. A small number of endourologic procedures offer the posibility to treat large BPH. Thus, laser surgery seems to be a salvage treatment for pacients with contrindications for classical open surgery. Aim of the study. The efficiency assesment of transurethral Thulium YAG laser vapoenucleation of prostate (ThuVEP). Materials and methods.. 16 patients with average age of 71 years underwent surgical treatment of large BPH. All of them underwent ThuVEP. A 550 micron end fire laser fiber was used during vapoenucleation. 80W power setings were used in all of the pacients. The period of surveillance was of 6 months. Preoperative investigations: PSA, IPSS, QoL, TRUS-P withPVR and Qmax. Patients inclusion criteria: Prostate Volume ≥80cm3, IPSS ≥16 and PVR ≥ 50ml, PSA≤4ng / ml, QoL> 4. Results. Average duration of intervention: 76 min. The prostate volume decreased postoperative on average from 83,2 cm3 to 35,4 cm3, there was an increase of average Qmax from 8,2 to 19.3 ml/s, a decrease in mean IPSS from 21,3 to 7,1, and PVR diminished from 69,1 ml to 16,1 ml. The period of transitional macrohematuria was 2,1 days. The duration of cateterization was 2,5 and mean hemoglobin drop was 2,1 g/l. Conclusions. ThuVEP is an effective method for endourologic treatment of large BPH. Immediate postoperative results of ThuVEP are promising. It is to mention a high haemorrage safe features of ThuVEP.