Thulium:YAG laser enucleation (VapoEnucleation) of the prostate: safety and durability during intermediate-term follow-up.
OBJECTIVE
Thulium:YAG (Tm:YAG) VapoEnucleation has been introduced and relief of obstruction was demonstrated. The aim of this study was to proof durability of the outcomes in patients with an postoperative follow-up >12 month.


METHODS
VapoEnucleation was performed using a 70 Watt continuous-wave-laser. After enucleation tissue was morcellated within the bladder. Patients were followed in terms of improvement of uroflow, intra- and postoperative course and for occurring complications.


RESULTS
88 consecutive patients with prostatic enlargement underwent our initial series of 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). Foley catheter-time was 2.1 +/- 1.06 days on average. In 79/88 patients the postoperative period extended 12 month (mean: 16.5 month). 2 patients deceased during the follow-up, 15 patients did not respond. Therefore, 62/77 patients were available for follow-up. Flow-rate and post-voiding residual urine improved significantly [3.5 vs. 23.3 ml/s (p < 0.001); 121.3 vs. 33.4 ml (p < 0.05)]. IPSS decreased from 18.4 to 6.8, QoL dropped from 4.6 to 1.4. Early complications were urinary tract infection (n: 6/6.8%), bleeding (n: 5/5.6%) and immediate re-treatment (n: 2/2.2%), as well as urethral stricture (n: 1/1.6%) during follow-up. Postoperative short-term dysuria was recorded in 27% of the patients.


CONCLUSIONS
VapoEnucleation is a safe and effective minimal invasive treatment modality for BPO. The improvement in voiding and bother is durable in patients with a postoperative period extending 12 month.
Bach
Thorsten
T
Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany. thorsten.bach@umm.de
Netsch
Christopher
C
Haecker
Axel
A
Michel
Maurice-Stephan
MS
Herrmann
Thomas R W
TR
Gross
Andreas J
AJ
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013932:Thulium / Q000627:therapeutic use*; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods*
D013932:Thulium