Abstract:
Abstract
Introduction. According to the current recommendations of the European Association of Urology and the International Society of Urology, open simple prostatectomy is
the reference standard in the surgical treatment of benign
prostatic hyperplasia of large size (>80 ml). Extended trauma and a high complication rate reduce the chances to use
this method. In this context, several minimally invasive laser
surgical treatment techniques have been proposed in order
to provide an optimal treatment to patients. Transurethral
endoscopic vapoenucleation of the prostate using laser energy is a new concept in endourological surgery.
Material and methods. Between September 2019 and
December 2019, 93 patients with benign prostatic hyperplasia underwent surgical treatment. Two surgical methods
were applied: transurethral Thulium:YAG laser prostate
vapoenucleation (45 patients) and open simple prostatectomy (48 patients). All patients were evaluated preoperatively and postoperatively (3 and 6 months) using the International Prostate Symptom Score, Quality of Life Score and
International Erectile Function Index, physical examination
and digital rectal examination, prostate specific antigen assessment, transrectal prostate ultrasound examination and
assessment of residual urine volume, uroflowmetry. Postoperative complications were recorded according to the
Clavien-Dindo classification, 2004. The inclusion criteria
were total prostate volume ≥80 cm3, age ≤80 years, residual
urine volume ≥70 ml, Qmax ≤10 ml/s.
Results. Transurethral Thulium:YAG laser vaponucleation of prostate has proven a high surgical efficiency level.
The baseline urodynamic and ultrasonographic indicators
after transurethral vapoenucleation at 6 months postoperatively were similar to those in the control group (open
simple prostatectomy). The duration of recovery of patients
after classical surgery was significantly longer. At the same
time, the rate of postoperative complications after prostate
vapoenucleation was lower. Patients in the ThuVEP group
did not require blood transfusions.
Conclusions. According to obtained results, we can assume that transurethral vapoenucleation of the prostate
with laser energy will soon become a new „gold standard”
in the surgical treatment of large benign prostate hyperplasia.
