title: Long-term results of thulium laser resection of the prostate: a prospective study at multiple centers.
abstract: OBJECTIVE
  To evaluate the long-term durability and complication rates after thulium laser resection of prostate (TmLRP) through a prospective multiple-center study.
  
  
  METHODS
  From November 2004 to December 2011, we prospectively studied 2,216 patients with symptomatic benign prostatic hyperplasia (BPH) treated with thulium laser resection of the prostate at four medical centers. Patients were assessed on International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR). Perioperative complications were classified according to the modified Clavien classification system.
  
  
  RESULTS
  Of 2,216 patients treated with TmLRP, 1,353 (61.1 %), 1,129 (50.9 %), 847 (38.2 %), and 541 (24.4 %) patients were followed at 5, 6, 7, and 8 years, respectively. Postoperatively, IPSS, QoL, Qmax, and PVR showed a significant improvement from 3 month after surgery and remained significantly improved during the entire follow-up period (p < 0.01). Minor complications occurred in 526 (23.7 %) of the 2,216 patients (Clavien 1: 21.5 %; Clavien 2: 2.3 %). Major complications requiring re-interventions occurred in 48 (2.2 %) of the 2,216 patients (Clavien 3: 2.2 %). No Clavien 4 or Clavien 5 complication had occurred. Urethral stricture and bladder neck contracture occurred in 2.6 % (58) and 1.6 % (35) patients, respectively. Persistent stress incontinence was found in 0.1 % (2) of the patients. Re-operation as a result of BPH recurrence was required in 1.2 % (27) patients.
  
  
  CONCLUSIONS
  Thulium laser resection of the prostate is a safe and effective procedure with excellent durability in the treatment of symptomatic BPH.
authors.affiliation: Department of Urology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, No.100, Haining Road, Shanghai, 200080, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Sun
authors.forename: Bangmin
authors.initials: B
authors.lastname: Han
authors.forename: Di
authors.initials: D
authors.lastname: Cui
authors.forename: Fujun
authors.initials: F
authors.lastname: Zhao
authors.forename: Xiaowen
authors.initials: X
authors.lastname: Sun
authors.forename: Jian
authors.initials: J
authors.lastname: Zhuo
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Jing
authors.forename: Haitao
authors.initials: H
authors.lastname: Liu
authors.forename: Shujie
authors.initials: S
authors.lastname: Xia
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.forename: Guangheng
authors.initials: G
authors.lastname: Luo
authors.forename: Fengfu
authors.initials: F
authors.lastname: Guo
mesh_terms: D000368:Aged; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation; D013932:Thulium; D016896:Treatment Outcome
chemical_list: D013932:Thulium