title: [Thulium vapoenucleation of prostates larger than 80 ml using a 1.9-µm and a 2-µm thulium laser. Early perioperative results from two centres].
abstract: BACKGROUND
  Numerous studies have shown that thulium vapoenucleation of the prostate (ThuVEP) is a size-independent minimally invasive procedure for the treatment of benign prostatic enlargement. All ThuVEP series have been performed with a 2-µm thulium laser device so far. The aim of this study was to evaluate the complications and early postoperative results of two thulium-devices with different wavelengths for ThuVEP in prostates larger than 80 ml.
  
  
  METHODS
  A retrospective bi-centric matched-paired analysis with 296 patients was performed. Based on prostate size, 148 were matched at each centre and laser device, respectively. A 2-µm (RevoLix, LISA Laser products, Katlenburg, Germany n=148) and a 1.9-µm (vela XL, starmedtec, Starnberg, Germany, n=148) thulium laser with a power output of 90 and 80 W was used. Patients' data were assessed and compared.
  
  
  RESULTS
  The median prostate volume (interquartile) was 100 ml (range 86.25-120 ml). At discharge, Qmax (preoperative 7.9 and 9 ml/s vs. postoperative 19.35 and 16.2 ml/s) and postvoiding-residual urine (preoperative 130 and 45 ml vs. postoperative 20 and 25 ml) were significantly improved after 2-µm and 1.9-µm ThuVEP (p<0.001). The median catheterization time and hospitalization times were 2 and 4 days in both groups. Perioperative complications occurred in 89 patients (30.1%): Clavien 1 (12.2%), Clavien 2 (9.1%), Clavien 3a (0.7%), Clavien 3b (7.1%), and Clavien 4a (1%). Regarding the occurrence of complications, there were no differences between the two thulium devices.
  
  
  CONCLUSIONS
  ThuVEP represents a safe and effective treatment for prostates larger than 80 ml. Both thulium laser devices give satisfactory immediate micturition improvement with low perioperative morbidity.
authors.affiliation: Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland. c.netsch@asklepios.com.
authors.forename: C
authors.initials: C
authors.lastname: Netsch
authors.affiliation: Abteilung für Urologie, Urologische Klinik Sindelfingen, Sindelfingen, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Knoll
authors.affiliation: Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
authors.forename: A J
authors.initials: AJ
authors.lastname: Gross
authors.affiliation: Abteilung für Urologie, Urologische Klinik Sindelfingen, Sindelfingen, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Wendt-Nordahl
mesh_terms: D000368:Aged; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D013932:Thulium; D016896:Treatment Outcome
chemical_list: D013932:Thulium
keywords: Catheterization time; Laser therapy; Length of stay; Micturition parameters; Prostate hyperplasia