title: Thulium Vaporesection of the Prostate and Thulium Vapoenucleation of the Prostate in Patients on Oral Anticoagulants: A Retrospective Three-Centre Matched-Paired Comparison.
abstract: BACKGROUND
  To evaluate the short-term results of thulium vaporesection of the prostate (ThuVEP) and thulium vapoenucleation of the prostate (ThuVARP) in patients with benign prostatic obstruction on oral anticoagulants (OA).
  
  
  METHODS
  A 3-centre retrospective matched-paired comparison of patients treated by ThuVEP (n = 26) or ThuVARP (n = 26) was performed. Thirty-four patients were on aspirin/ticlopidin, 7 on clopidogrel or clopidogrel and aspirin, and 11 on phenprocoumon at the time of surgery.
  
  
  RESULTS
  Haemoglobin decrease was higher after ThuVEP compared to ThuVARP (1.5 vs. 0.3 g/dl, p < 0.001). The rate of postoperative blood transfusions (3.9 vs. 0%), clot retention (3.9 vs. 0%), and re-operation (7.7 vs. 0%) was not different between ThuVEP and ThuVARP (p = 0.274). Catheterization time was shorter for ThuVARP (1 vs. 2 days, p < 0.01). Qmax was significantly higher after ThuVEP at 6-month follow-up (31 vs. 21.5 ml/s, p < 0.001), while improvements in International Prostate Symptom Score, quality of life, and post-voiding residual urine showed no differences between the groups. Urethral or bladder neck strictures did not occur during the 6-month follow-up in both groups.
  
  
  CONCLUSIONS
  ThuVEP and ThuVARP are safe and efficacious procedures in patients on OA. Although patients assigned to ThuVEP had higher Qmax at 6-month follow-up, ThuVARP resulted in similar functional outcomes.
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Netsch
authors.forename: Carlo
authors.initials: C
authors.lastname: Magno
authors.forename: Salvatore
authors.initials: S
authors.lastname: Butticè
authors.forename: Luciano
authors.initials: L
authors.lastname: Macchione
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mucciardi
authors.forename: Thomas R W
authors.initials: TR
authors.lastname: Herrmann
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Gross
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D016555:Matched-Pair Analysis; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012189:Retrospective Studies; D013932:Thulium
chemical_list: D000925:Anticoagulants; D013932:Thulium