Thulium:yttrium-aluminium-garnet laser prostatectomy in men with refractory urinary retention.
OBJECTIVE
To evaluate the feasibility and efficacy of thulium:yttrium-aluminium-garnet (YAG) laser prostatectomy in patients with an indwelling transurethral catheter due to recurrent urinary retention secondary to benign prostatic obstruction.


METHODS
Preoperative data and postoperative outcome, as well as complications, were recorded in 65 patients with a history of recurrent urinary retention before surgery (group A), who were compared with a group of 143 men with no recurrent urinary retention (group B).


RESULTS
The mean (sd) volume of the prostate was 45.6 (22.5) and 43.1 (24.5) mL in groups A and B, respectively. The respective preoperative prostate-specific antigen levels were 3.6 (7.8) and 2.8 (6.4) ng/mL, the surgical duration 72.4 (28.9) and 65.6 (28.6) min, the mean laser time and energy 32.5 (11.8) min/140.7 (42.1) kJ and 29.4 (11.6) min/117.6 (11.6) kJ, the maximum urinary flow rate after surgery 19.6 (11.2) and 19.1 (9.6) mL/s, and the postvoid residual urine volume 26.7 (36.3) and 20.6 (27.3) mL. Recorded complications were: bleeding, at 3% in group A and 1.4% in group B; urinary tract infection 15.4% and 4.2%; and a second procedure, 3% and 2.3%. Overall, complications were more frequent in group A (P = 0.02).


CONCLUSIONS
Thulium:YAG prostatectomy is feasible and effective, even in patients with potentially impaired detrusor function. The long-term durability of these promising results has yet to be confirmed.
Bach
Thorsten
T
Department of Urology, University Hospital Mannheim, Mannheim, Germany. thorsten.bach@uro.ma.uniheidelberg.de
Herrmann
Thomas R W
TR
Haecker
Axel
A
Michel
Maurice S
MS
Gross
Andreas
A
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004812:Epidemiologic Methods; D006801:Humans; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000592:standards / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D013932:Thulium / Q000627:therapeutic use*; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology / Q000601:surgery*
D013932:Thulium