title: Vapoenucleation of the prostate using a high-power thulium laser: a one-year follow-up study.
abstract: BACKGROUND
  Prostate vaporization and enucleation is a novel treatment option for bladder outlet obstruction caused by benign prostate enlargement. This surgical technique, however, has not yet been standardized. We present our findings of using a high-power thulium laser to accomplish vapoenucleation of the prostate (ThuVEP).
  
  
  METHODS
  We prospectively collected and analyzed data from 29 patients who underwent ThuVEP between August 2010 and May 2012. The control group included 30 patients who underwent traditional transurethral resection of the prostate (TURP). Operative variables, patient profiles, preoperative and postoperative urine flow rates, prostate volume (measured using transrectal ultrasonography), and the international prostate symptom score (IPSS) were recorded and analyzed using a two-tailed Student's t-test and analysis of variance.
  
  
  RESULTS
  The ages (mean ± SD) of the patients were 76.1 ± 9.4 and 72.6 ± 7.4 years (p = 0.28) in the ThuVEP and TURP groups, respectively. The average urinary flow rates before and 12 months after the operation (volume/maximum flow/average flow) were 243.3/10.5/5.0 and 302.8/17.6/9.4 (in mL, mL/s, mL/s, respectively) in the ThuVEP group and 247.2/10.8/4.6 and 369.9/20.8/12.0, respectively, in the TURP group. Preoperative and postoperative IPSSs were 17.1 ± 5.0 and 6.5 ± 3.8, respectively, in the ThuVEP group and 18.2 ± 4.5 and 6.2 ± 3.3, respectively, in the TURP group. The mean ratio of the estimated postoperative residual prostate volume to the preoperative total volume was 0.47 (p = 0.449) in both groups. The overall complication rate was 20.7% in the ThuVEP group and 30.0% in the TURP group.
  
  
  CONCLUSIONS
  One year of follow-up showed that ThuVEP and TURP effectively alleviated subjective and objective voiding symptoms with a low rate of complications. Thus, vapoenucleation using a high-power laser is feasible in elderly patients.
  
  
  BACKGROUND
  ISRCTN registry with study ID ISRCTN52339705 . Date assigned: 06/03/2015.
authors.affiliation: Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan. jossp1029@gmail.com.|Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan. jossp1029@gmail.com.|Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan. jossp1029@gmail.com.
authors.forename: Ching-Hsin
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan. tplin63@gmail.com.|Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan. tplin63@gmail.com.|Shu-Tien Urological Science Research Center, Taipei, Taiwan. tplin63@gmail.com.
authors.forename: Tzu-Ping
authors.initials: TP
authors.lastname: Lin
authors.affiliation: Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan. yhchang@vghtpe.gov.tw.|Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan. yhchang@vghtpe.gov.tw.|Shu-Tien Urological Science Research Center, Taipei, Taiwan. yhchang@vghtpe.gov.tw.
authors.forename: Yen-Hwa
authors.initials: YH
authors.lastname: Chang
authors.affiliation: Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan. jshuang@vghtpe.gov.tw.|Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan. jshuang@vghtpe.gov.tw.|Shu-Tien Urological Science Research Center, Taipei, Taiwan. jshuang@vghtpe.gov.tw.
authors.forename: William J S
authors.initials: WJ
authors.lastname: Huang
authors.affiliation: Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan. lin.alextl@gmail.com.|Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan. lin.alextl@gmail.com.|Shu-Tien Urological Science Research Center, Taipei, Taiwan. lin.alextl@gmail.com.
authors.forename: Alex T L
authors.initials: AT
authors.lastname: Lin
authors.affiliation: Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan. kkchen@vghtpe.gov.tw.|Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan. kkchen@vghtpe.gov.tw.|Shu-Tien Urological Science Research Center, Taipei, Taiwan. kkchen@vghtpe.gov.tw.
authors.forename: Kuang-Kuo
authors.initials: KK
authors.lastname: Chen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013932:Thulium; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016055:Urinary Retention / Q000209:etiology / Q000503:physiopathology / Q000601:surgery
chemical_list: D013932:Thulium