title: One day surgery in the treatment of benign prostatic enlargement with thulium laser: A single institution experience.
abstract: OBJECTIVE
  Various articles have previously addressed the introduction of new surgical laser therapies for an enlarged prostate gland causing obstructive symptoms. The objective of this study was to report the feasibility of performing the thulium laser vapo-enucleation of the prostate (ThuVEP) procedure for benign prostatic obstruction in a 1-day surgery.
  
  
  METHODS
  From September 2011 to September 2013, we conducted a prospective study on patients who underwent ThuVEP in a 1-day surgery. The primary outcomes measured perioperatively included operative time, resected tissue weight, hemoglobin decrease, transfusion rate, postoperative irrigation and catheterization time, and postoperative hospital stay. Also, the preoperative and postoperative International Prostate Symptom Score (IPSS) and results of uroflowmetry performed on the 7th and 30th postoperative days were recorded. All perioperative and postoperative complications were monitored.
  
  
  RESULTS
  A total of 53 patients underwent the surgical treatment in a 1-day surgery. Seven patients continued antiaggregant therapy with aspirin. Mean preoperative prostatic adenoma volume was 56.6 mL. Mean operative time was 71 minutes. The average catheter time was 14.8 hours. The peak urinary flow rate on day 7 improved from 9.3 to 17.42 mL/s (p<0.001) and the IPSS improved from 18 to 10.2 (p<0.01). Patients were routinely discharged on the day of catheter removal. No complications were recorded.
  
  
  CONCLUSIONS
  ThuVEP can be safely conducted as a 1-day surgical procedure. This strategy results in cost savings. ThuVEP shows good standardized outcomes with respect to improvement in flow parameters and length of bladder catheterization.
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Carmignani
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Macchi
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Ratti
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Finkelberg
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Casellato
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Maruccia
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Marenghi
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Stefano Carlo Maria
authors.initials: SC
authors.lastname: Picozzi
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013932:Thulium / Q000627:therapeutic use*; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome
chemical_list: D013932:Thulium
keywords: Lasers; Prostate; Prostatic hyperplasia; Thulium