title: Thulium Laser Prostate Enucleation in Refractory Urinary Retention: Operative and Functional Outcomes in a Large Cohort of Patients.
abstract: OBJECTIVE
  To evaluate the functional and operative results of thulium laser enucleation of the prostate (ThuLEP) in patients with indwelling catheters for refractory urinary retention.
  
  
  METHODS
  Patients with indwelling catheter, undergoing ThuLEP for benign prostate hyperplasia, were prospectively enrolled. Every episode of urinary retention was treated with urinary catheter positioning followed by at least 2 attempts of catheter removal. Patients were investigated with flowmetry and the self-administered International Prostate Symptom Score questionnaire at 30 and 90 days following ThuLEP.
  
  
  RESULTS
  Three hundred eighty-one patients underwent ThuLEP, and 99 of these had indwelling catheters, but only 93 (24%) were eligible according to the inclusion criteria. In 46 patients the bladder catheter was removed on the first postoperative day, in 31 patients on the second postoperative day, in 5 patients on the third postoperative day, in 6 patients on the fourth postoperative day, in 1 patient on the fifth postoperative day, and in 2 patients each on the sixth and seventh postoperative days. The average hospital stay was 2.3 (±1.7) days. No patients undergoing ThuLEP, at the 90-day follow-up, required further catheterization. Flowmetry showed significant improvement in all parameters, and the mean International Prostate Symptom Score dropped from 21.33 preoperatively to 3.2 (P = .004) at 90 days postoperatively.
  
  
  CONCLUSIONS
  This prospective study shows that ThuLEP is a safe and effective approach in refractory urinary retention patients. In our case series, no patients required postoperative intermittent catheterization. All functional outcomes investigated reported a statistical significant improvement.
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Carmignani
authors.affiliation: Urology Division, Department of Medico Surgical Sciences and Biotechnologies, Sapienza University of Rome, Faculty of Pharmacy and Medicine, Latina, Italy.
authors.forename: Antonio Luigi
authors.initials: AL
authors.lastname: Pastore
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Stefano Carlo Maria
authors.initials: SC
authors.lastname: Picozzi
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: Dario
authors.initials: D
authors.lastname: Ratti
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Vizziello
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Schirinzi
authors.affiliation: Department of Urology, AO Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Saccà
authors.affiliation: Department of Urology, AO Città della Salute e della Scienza, University of Turin, Turin, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pisano
authors.affiliation: Department of Urology, IRCCS Policlinico San Donato, Milan, Italy. Electronic address: serena.maruccia.urologia@gmail.com.
authors.forename: Serena
authors.initials: S
authors.lastname: Maruccia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000601:surgery*; D020127:Recovery of Function; D013932:Thulium / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology* / Q000601:surgery*
chemical_list: D013932:Thulium