A prospective, randomized trial comparing thulium vapoenucleation with holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic obstruction: perioperative safety and efficacy.
World J Urol
; 35(12): 1913-1921, 2017 Dec.
Article
in En
| MEDLINE
| ID: mdl-28698991
ABSTRACT
INTRODUCTION AND OBJECTIVES:
To compare the perioperative outcomes of thulium vapoenucleation of the prostate (ThuVEP) with holmium laser enucleation of the prostate (HoLEP) for patients with symptomatic benign prostatic obstruction (BPO).METHODS:
Forty-eight and 46 patients were prospectively randomized to ThuVEP and HoLEP. All patients were assessed preoperatively and 4-week postoperatively. The complications were noted and classified according to the modified Clavien classification system. Patient data were expressed as median (interquartile range) or numbers (%).RESULTS:
Median age at surgery was 73 (67-76) years and median prostate volume was 80 (46.75-100) cc and not different between the groups (p = 0.207). The median operative time was 60 (41-79) minutes without significant differences between both groups (p = 0.275). There were no significant differences between the groups regarding catheterization time [2 (2-2) days, p = 0.966] and postoperative stay [2 (2-3) days, p = 0.80]). Clavien 1 (13.8%), Clavien 2 (3.2%), Clavien 3a (2.1%), and Clavien 3b (4.3%) complications occurred without significant differences between the groups. However, the occurrence of acute postoperative urinary retention was higher after HoLEP compared to ThuVEP (15.2 vs. 2.1%, p ≤ 0.022). At 1-month follow-up, peak urinary flow rates (10.7 vs. 22 ml/s), post-void residual volumes (100 vs. 20 ml), International Prostate Symptom Score (20 vs. 10) and Quality of Life (4 vs. 3) had improved significantly (p ≤ 0.005) without significant differences between the groups.CONCLUSIONS:
ThuVEP and HoLEP are safe and effective procedures for the treatment of symptomatic BPO. Both procedures give equivalent and satisfactory immediate micturition improvement with low perioperative morbidity.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Prostatectomy
/
Prostatic Hyperplasia
/
Thulium
/
Prostatism
/
Laser Therapy
/
Lasers, Solid-State
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
Aspects:
Patient_preference
Limits:
Aged
/
Humans
/
Male
Language:
En
Journal:
World J Urol
Year:
2017
Document type:
Article
Affiliation country:
Germany