title: High-power thulium laser vaporization of the prostate: short-term outcomes of safety and effectiveness.
abstract: BACKGROUND
  The thulium laser was introduced in 2005 for the treatment of benign prostatic hyperplasia (BPH). Enucleation studies from outside North America show comparable efficacy and lower morbidity to transurethral resection of the prostate. A few studies exist describing outcomes of vaporization, the most commonly used technique for urologists. We present our 3-month outcomes of thulium laser vaporization of the prostate (ThuVP).
  
  
  METHODS
  From December 2010 to October 2013, 68 men underwent ThuVP using the 150 W CyberTM(®). Data were collected on demographics, comorbidities, intraoperative measures, complications, serum parameters, maximum flow rate (Qmax), postvoid residual (PVR), International Prostate Symptom Score (IPSS), quality-of-life (QoL) score, and prostate-specific antigen. Patients were evaluated at 1 week, 1 month, and 3 months postoperatively. Nine patients were excluded for known prostate cancer.
  
  
  RESULTS
  The mean age was 66±10 years, with a mean prostate size of 57±30 mL. At baseline, the mean IPSS was 19.9±8.0, QoL score was 4.5±1.1, Qmax was 5.2±4.5 mL/sec, and PVR was 220±397 mL. The mean laser time was 35±18 minutes, and energy used was 234±139 kJ. Forty-seven (78%) patients were discharged the day of surgery. No blood transfusions were administered with a mean drop in hemoglobin of 0.7±0.8 g/dL (p<0.05). There were no Clavien grade≥III complications within 30 days of surgery. Six (10%) patients were diagnosed with urinary tract infection. Significant improvements from baseline were seen in Qmax, PVR, IPSS, and QoL score. All 15 patients who were in retention were voiding at the last follow-up.
  
  
  CONCLUSIONS
  Thulium laser vaporization of the prostate appears to be a safe and effective outpatient technique for the treatment of BPH with durable outcomes at 3 months.
authors.affiliation: 1 Section of Urology, University of Chicago , Chicago, Illinois.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Pariser
authors.forename: Olufenwa J
authors.initials: OJ
authors.lastname: Famakinwa
authors.forename: Shane M
authors.initials: SM
authors.lastname: Pearce
authors.forename: Doreen E
authors.initials: DE
authors.lastname: Chung
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017430:Prostate-Specific Antigen / Q000032:analysis; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012449:Safety; D013932:Thulium / Q000627:therapeutic use*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000209:etiology; D014554:Urination / Q000502:physiology; D014835:Volatilization
chemical_list: D015415:Biomarkers; D013932:Thulium; D017430:Prostate-Specific Antigen