[TULIP--transurethral ultrasound-controlled laser-induced prostatectomy: an alternative to TURP?].
Transurethral resection of the prostate (TURP) is the most effective treatment for prostatic obstruction secondary to benign prostatic hyperplasia (BPH). This procedure has a high success rate with a very low mortality rate. Over the last 30 years, however, an unchanged morbidity rate of about 20% following TURP has been reported in the literature. In addition, haemorrhage requiring blood transfusion may occur in 6.5-22% of cases, and 68-92% of sexually active men have retrograde ejaculation following TURP. The side-effects and complications associated with TURP have led to the search for alternative therapies. The TULIP system represents a new treatment modality. TULIP is an acronym for transurethral ultrasound-guided laser-induced prostatectomy. The basic TULIP system consists of an ultrasound imager and a 20-F transurethral probe with an ultrasound transducer and a laser window at the distal end. Under ultrasound guidance laser treatment results in a coagulation necrosis effect in the hyperplastic prostate tissue. Coagulation necrosis is basically a bloodless tissue removal procedure as the tissue subsequently sloughs away in the fine particles during spontaneous micturation within 4-6 weeks after the procedure. Early results obtained in the first 18 patients with symptomatic, obstructive BPH treated by TULIP and with a follow-up of 6 weeks to 6 months demonstrate a significant improvement in both subjective and objective symptoms. The peak flow rate increased by up to 142% on average; the residual volume decreased by up to 75%; and there was a 77% decrease in average symptom scores compared with preoperative scores.(ABSTRACT TRUNCATED AT 250 WORDS)
Schulze
H
H
Urologische Klinik, Ruhr-Universität Bochum, Marienhospital Herne.
Martin
W
W
Engelmann
U
U
Senge
T
T
D000368:Aged; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011468:Prostatectomy / Q000295:instrumentation*; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D014463:Ultrasonography / Q000295:instrumentation*; D001748:Urinary Bladder Neck Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology