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1.
Int. braz. j. urol ; 48(2): 328-335, March-Apr. 2022. tab
Article in English | LILACS | ID: biblio-1364937

ABSTRACT

ABSTRACT Objectives: To compare thulium laser enucleation of prostate (ThuLEP) versus laparoscopic trans-vesical simple prostatectomy (LSP) in the treatment of benign prostatic hyperplasia (BPH). Materials and Methods: Data of patients who underwent surgery for "large" BPH (>80mL) at three Institutions were collected and analyzed. Two institutions performed ThuLEP only; the third institution performed LSP only. Preoperative (indwelling catheter status, prostate volume (PVol), hemoglobin (Hb), Qmax, post-voiding residual volume (PVR), IPSS, QoL, IIEF-5) and perioperative data (operative time, enucleated adenoma, catheterization time, length of stay, Hb-drop, complications) were compared. Functional (Qmax, PVR, %ΔQmax) and patient-reported outcomes (IPSS, QoL, IIEF-5, %ΔIPSS, %ΔQoL) were compared at last follow-up. Results: 80 and 115 patients underwent LSP and ThuLEP, respectively. At baseline, median PVol was 130 versus 120mL, p <0.001; Qmax 9.6 vs. 7.1mL/s, p=0.005; IPSS 21 versus 25, p <0.001. Groups were comparable in terms of intraoperative complications (1 during LSP vs. 3 during ThuLEP) and transfusions (1 per group). Differences in terms of operative time (156 vs. 92 minutes, p <0.001), Hb-drop (-2.5 vs. −0.9g/dL, p <0.001), catheterization time (5 vs. 2 days, p <0.001) and postoperative complications (13.8% vs. 0, p <0.001) favored ThuLEP. At median follow-up of 40 months after LSP versus 30 after ThuLEP (p <0.001), Qmax improved by 226% vs. 205% (p=0.5), IPSS decreased by 88% versus 85% (p=0.9), QoL decreased by 80% with IIEF-5 remaining almost unmodified for both the approaches. Conclusions: Our analysis showed that LSP and ThuLEP are comparable in relieving from BPO and improving the patient-reported outcomes. Invasiveness of LSP is more significant.


Subject(s)
Humans , Male , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/complications , Laparoscopy , Laser Therapy , Lasers, Solid-State/therapeutic use , Prostate/surgery , Prostatectomy , Quality of Life , Thulium/therapeutic use , Treatment Outcome
2.
Asian Journal of Andrology ; (6): 191-194, 2022.
Article in English | WPRIM | ID: wpr-928523

ABSTRACT

Benign prostatic hyperplasia (BPH) is a common disease in elderly men, and transurethral laser prostatectomy (TULP) has been widely used in the clinic to remove bladder outlet obstruction caused by BPH. Previous animal models for wound repair after prostatectomy have many limitations, and there have been no previous reports of a mouse model of TULP. Therefore, this study aimed to establish a novel mouse model of TULP. Twelve healthy adult Kunming (KM) mice received transurethral laser vaporization prostatectomy with a 200-μm thulium laser. The mice were sacrificed, and wound specimens from the prostatic urethra and bladder neck were harvested at 1 day, 3 days, 5 days, and 7 days after surgery. Hematoxylin-eosin (HE) and immunohistochemistry were applied to confirm the establishment of the mouse TULP model. One day after the surgery, urothelium expressing uroplakin (UPK) was absent in the urethral wound site, and a large number of necrotic tissues were found in the wound site. There was no UPK-positive urothelium in the wound 3 days after surgery. At 5 days after surgery, monolayer urothelium expressing UPK was found in the wound site, indicating that the re-epithelization of the wound had been completed. On the 7th day after surgery, there were multiple layers of urothelium with UPK expression, indicating that the repair was completed. It is feasible to establish a mouse TULP model by using a microcystoscope system and a 200-μm thulium laser.


Subject(s)
Aged , Animals , Humans , Male , Mice , Laser Therapy , Prostatectomy , Prostatic Hyperplasia/surgery , Thulium , Transurethral Resection of Prostate
4.
Journal of the Korean Medical Association ; : 401-408, 2017.
Article in Korean | WPRIM | ID: wpr-156629

ABSTRACT

Benign prostatic hyperplasia (BPH) is one of the most common urological diseases in men after middle age. The most common surgical treatment of BPH is transurethral prostatectomy. Recently, because of the rapid development of lasers, they have been used for the treatment of BPH. The treatment of BPH using lasers has been shown to lead to significant improvements in symptoms and to have excellent therapeutic effects. It is widely used as a minimally invasive treatment of BPH because of the risk and complications associated with transurethral prostate resection. Currently, 3 kinds of lasers are generally used in the treatment of BPH in Korea: potassium-titanyl-phosphate, holmium, and thulium lasers. With developments in laser technology, surgical procedures have improved continuously. The most common surgical procedures are holmium laser enucleation of the prostate (HoLEP), photoselective vaporization of the prostate (PVP), and thulium laser enucleation of the prostate. HoLEP is an effective surgical procedure for large prostates. PVP is safe for patients who are elderly, are in poor general health, or are taking anticoagulants. Thulium laser enucleation of prostate has advantages over PVP and HoLEP surgery due to specific characteristics of the laser and the surgical method. Compared with transurethral prostate resection, laser-based surgical procedures require shorter hospitalization and Foley catheter insertion periods. HoLEP and PVP are safe and effective methods for the surgical treatment of BPH. Therefore, if more data are accumulated from research into these methods, they will become the standard surgical treatments for prostate hyperplasia.


Subject(s)
Aged , Humans , Male , Middle Aged , Anticoagulants , Catheters , Holmium , Hospitalization , Hyperplasia , Korea , Lasers, Solid-State , Methods , Prostate , Prostatic Hyperplasia , Therapeutic Uses , Thulium , Transurethral Resection of Prostate , Urologic Diseases , Volatilization
5.
National Journal of Andrology ; (12): 1085-1088, 2017.
Article in Chinese | WPRIM | ID: wpr-812830

ABSTRACT

Objective@#To compare thulium laser vaporization of the prostate (TLVP) and transurethral resection of the prostate (TURP) in the treatment of benign prostate hyperplasia (BPH) analyze the risk factors for postoperative urethral stricture.@*METHODS@#From June 2015 to June 2016, 210 BPH patients in our hospital underwent TURP (n = 126) or TLVP (n = 84). We followed up the patients for 6 months, compared the effects of the two surgical strategies and analyzed the risk factors for postoperative urethral stricture by multivariate logistic regression analysis.@*RESULTS@#Compared with TURP, TLVP achieved significantly shorter time of operation ([78.6 ± 27.5] vs [53.2 ± 21.6] min, P <0.01), postoperative bladder irrigation ([31.5 ± 2.9] vs [26.1 ± 3.7] h, P <0.01), urethral catheterization ([5.3 ± 1.7] vs [3.7 ± 1.5] d, P <0.01) and postoperative hospitalization ([7.9 ± 2.1] vs [5.5 ± 1.4] d, P <0.01) as well as lower urinary leukocyte count at 6 months after surgery ([32.1 ± 12.6] vs [24.9 ± 11.7] /μl, P <0.01) and incidence rate of postoperative complications (11.9% [15/126] vs 3.6% [3/84], P <0.05), particularly that of urethral stricture (7.9% [10/126] vs 1.2% [1/84], P <0.05). Logistic regression analysis showed that the preoperative urinary leukocyte count, postoperative urethral catheterization time, and surgical method were independent risk factors for postoperative urethral stricture.@*CONCLUSIONS@#TLVP, in comparison with TURP, has the advantages of definite effect, fast recovery, high safety and low incidence of postoperative urethral stricture. The main risk factors for postoperative urethral stricture include preoperative urinary tract infection, postoperative urethral catheterization time and surgical method.


Subject(s)
Humans , Male , Laser Therapy , Methods , Operative Time , Postoperative Complications , Prostatic Hyperplasia , General Surgery , Quality of Life , Regression Analysis , Risk Factors , Thulium , Therapeutic Uses , Transurethral Resection of Prostate , Treatment Outcome , Urethral Stricture , Urinary Catheterization , Urinary Tract Infections
6.
Int. braz. j. urol ; 42(4): 757-765, July-Aug. 2016. tab
Article in English | LILACS | ID: lil-794689

ABSTRACT

ABSTRACT Introduction: Thulium laser VapoEnucleation of the prostate (ThuVEP) is an evolving surgical technique for BPH. Most studies have focused on outcomes in small to medium sized prostates and have originated from Europe and Asia. We sought to describe our experience with ThuVEP for very large prostates in a North American cohort. Materials and Methods: From December 2010 to October 2014, 25 men underwent ThuVEP using the CyberTM® (Quantastem, Italy) thulium laser, all with prostate volume >75mL. Data collected included patient demographics, comorbidities, intraoperative parameters, complications, and post-operative outcomes including maximum flow rate (Qmax), post-void residual (PVR), International Prostate Symptom Score (IPSS), and quality of life score (QoL) in one year of follow-up. Statistical analysis was done using Wilcoxon signed-rank test. Results: At baseline, mean age was 70±9 years and prostate size was 163±62g. Most patients (84%) were in retention and 10 (40%) patients were on anticoagulation. Seven (28%) patients went home the day of surgery (mean hospital stay: 1.2±1.2d). There were 2 intraoperative complications (8%), both cystotomies related to morcellation. Nine patients (36%) experienced a complication, all within 30 days. There were no Clavien ≥III complications. Significant improvements were seen in Qmax, PVR, IPSS, and QoL score at each time interval to 12-months following surgery (all p<0.05). Of 21 patients initially in retention, all were voiding at last follow-up. Conclusions: Our findings suggest that ThuVEP is an effective treatment for BPH in patients with large prostates with sustained results for one year.


Subject(s)
Humans , Male , Aged , Aged, 80 and over , Prostatectomy/methods , Prostatic Hyperplasia/surgery , Thulium/therapeutic use , Laser Therapy , Lasers, Solid-State/therapeutic use , Organ Size , Prospective Studies , Treatment Outcome , Middle Aged
7.
Chinese Medical Journal ; (24): 884-889, 2015.
Article in English | WPRIM | ID: wpr-350383

ABSTRACT

<p><b>BACKGROUND</b>This study compared the efficacy and safety between 120-W thulium:yttrium-aluminum-garnet (Tm:YAG) vapoenucleation of prostates (ThuVEP) and holmium laser enucleation of prostates (HoLEP) for patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>A retrospective analysis of 88 consecutive patients with symptomatic BPH was carried out, who underwent either 120-W ThuVEP or HoLEP nonrandomly. Patient demographics and peri-operative and 12-month follow-up data were analyzed with the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum flow rate (Qmax), postvoid residual urine volume (PVR), and rates of peri-operative and late complications.</p><p><b>RESULTS</b>The patients in each group showed no significant difference in preoperative parameters. Compared with the HoLEP group, patients in the 120-W ThuVEP group required significantly shorter time for laser enucleation (58.3 ± 12.8 min vs. 70.5 ± 22.3 min, P = 0.003), and resulted in a significant superiority in laser efficiency (resected prostate weight/laser enucleation time) for 120-W Tm:YAG laser compared to holmium:YAG laser (0.69 ± 0.18 vs. 0.61 ± 0.19, P = 0.048). During 1, 6, and 12 months of follow-ups, the procedures did not demonstrate a significant difference in IPSS, QoL score, Qmax, or PVR (P > 0.05). Mean peri-operative decrease of hemoglobin in the HoLEP group was similar to the ThuVEP group (17.1 ± 12.0 g/L vs. 15.2 ± 10.1 g/L, P = 0.415). Early and late incidences of complications were low and did not differ significantly between the two groups of 120-W ThuVEP and HoLEP patients (P > 0.05).</p><p><b>CONCLUSIONS</b>120-W ThuVEP and HoLEP are potent, safe and efficient modalities of minimally invasive surgeries for patients with LUTS due to BPH. Compared with HoLEP, 120-W ThuVEP offers advantages of reduction of laser enucleation time and improvement of laser efficiency.</p>


Subject(s)
Aged , Humans , Male , Middle Aged , Aluminum , Therapeutic Uses , Laser Therapy , Prostate , General Surgery , Prostatic Hyperplasia , General Surgery , Quality of Life , Retrospective Studies , Thulium , Therapeutic Uses , Treatment Outcome , Yttrium , Therapeutic Uses
8.
National Journal of Andrology ; (12): 245-250, 2015.
Article in Chinese | WPRIM | ID: wpr-319511

ABSTRACT

<p><b>OBJECTIVE</b>To compare the effect and impact of holmium laser enucleation of the prostate (HoLEP) and 120-W thulium: YAG vapoenucleation of the prostate (ThuVEP) on erectile function in the treatment of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We retrospectively analyzed 93 cases of symptomatic BPH treated by HoLEP or 120 W ThuVEP. We made comparisons between the two groups of patients in the baseline and postoperative clinical and surgical indexes as well as their IPSS, quality of life (QOL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), and IIEF-EF scores before surgery and during the 12-month follow-up.</p><p><b>RESULTS</b>ThuVEP, in comparison with HoLEP, achieved a significantly shorter operation time ([57.6 +/- 12. 8] vs. [70.4 +/- 21.8] min, P = 0.001) and a higher laser efficiency ([0.71 +/- 0.18] vs. [0.62 +/- 0.19] g/min, P = 0. 021). At 1, 6, or 12 months of follow-up, no significant differences were observed in IPSS, OOL, Omax, and PVR between the two groups (P > 0.05). Both the HoLEP and ThuVEP groups showed low incidences of complications and remarkably improved IIEF-EF scores at 12 months postoperatively, but with no significant differences (both P > 0.05). However, in those with relatively normal erectile functions before operation, the mean IIEF-EF score was reduced from 22.8 +/- 2.2 preoperatively to 21.0 +/- 2.7 after HoLEP, (P = 0.036).</p><p><b>CONCLUSION</b>Both HoLEP and 120W ThuVEP are effective and safe in the treatment of BPH. Compared with HoLEP, 120 W ThuVEP has even a higher laser efficiency. However, neither can significantly improve erectile function, and HoLEP may have a short-term negative impact on the relatively normal erectile function of the patient.</p>


Subject(s)
Aged , Humans , Male , Middle Aged , Holmium , Laser Therapy , Methods , Lasers, Solid-State , Therapeutic Uses , Penile Erection , Prostatectomy , Methods , Prostatic Hyperplasia , General Surgery , Quality of Life , Retrospective Studies , Thulium , Transurethral Resection of Prostate , Treatment Outcome , Urine
9.
Korean Journal of Urology ; : 769-774, 2015.
Article in English | WPRIM | ID: wpr-198011

ABSTRACT

PURPOSE: The thulium laser is the most recently introduced technology for the surgical treatment of benign prostatic hyperplasia (BPH). Until recently, most thulium laser enucleation of the prostate (ThuLEP) was performed by use of the three-lobe technique. We introduce a novel one-lobe enucleation technique for ThuLEP called the "All-in-One" technique. We report our initial experiences here. MATERIALS AND METHODS: From June 2013 to May 2014, a total of 47 patients underwent the All-in-One technique of ThuLEP for symptomatic BPH performed by a single surgeon. All patients were assessed with the International Prostate Symptom Score (IPSS), transrectal ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR) before and 1 month after surgery. We reassessed IPSS, Qmax, and PVR 3 months after surgery. To assess the efficacy of the All-in-One technique, we checked the PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate. RESULTS: The mean operative time was 82.1+/-33.3 minutes. The mean enucleation time and morcellation time were 52.7+/-21.7 minutes and 8.2+/-7.0 minutes, respectively. The mean resected tissue weight and decrease in hemoglobin were 36.9+/-24.6 g and 0.4+/-0.8 g/dL, respectively. All perioperative parameters showed significant improvement (p<0.05). No major complications were observed. The PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate were 0.81, 0.92, and 4.3%, respectively. CONCLUSIONS: The All-in-One technique of ThuLEP showed efficacy and effectiveness comparable to that of other techniques. We expect that this new technique could reduce the operation time and the bleeding and improve the effectiveness of enucleation.


Subject(s)
Aged , Humans , Male , Middle Aged , Lasers, Solid-State/adverse effects , Operative Time , Prostate-Specific Antigen/blood , Prostatic Hyperplasia/pathology , Retrospective Studies , Thulium , Transurethral Resection of Prostate/adverse effects , Treatment Outcome
10.
Korean Journal of Urology ; : 365-369, 2015.
Article in English | WPRIM | ID: wpr-76181

ABSTRACT

PURPOSE: 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. MATERIALS AND 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.


Subject(s)
Aged , Humans , Male , Middle Aged , Ambulatory Surgical Procedures , Laser Therapy/adverse effects , Lasers, Solid-State/therapeutic use , Length of Stay , Operative Time , Prospective Studies , Prostate/surgery , Prostatic Hyperplasia/surgery , Thulium/therapeutic use , Transurethral Resection of Prostate , Treatment Outcome
11.
Korean Journal of Urology ; : 41-46, 2014.
Article in English | WPRIM | ID: wpr-7832

ABSTRACT

PURPOSE: In recent years, laser surgery has been widely used to treat benign prostatic hyperplasia (BPH). A thulium:yttrium-aluminium-garnet (Tm:YAG) laser was recently introduced for BPH surgery. We compared the effectiveness and safety of Tm:YAG laser vaporesection of the prostate (ThuVaRP) with that of bipolar transurethral resection of the prostate (TURP). MATERIALS AND METHODS: From January 2010 to December 2012, 86 patients underwent surgical treatment for symptomatic BPH by a single surgeon. We retrospectively analyzed and compared the medical records of 43 patients who underwent ThuVaRP and 43 patients who underwent bipolar TURP. All patients were assessed by using the International Prostate Symptom Score, transrectal ultrasonography, the serum prostate-specific antigen (PSA) level, uroflowmetry, and postvoid residual volume before and 1 month after surgery. All complications were compared between the two groups. RESULTS: ThuVaRP was superior to TURP in catheterization time (p50 g), operation time was much longer with ThuVaRP. One month after surgery, the decrease in PSA was greater (p=0.045) with ThuVaRP than with TURP, and the increase in maximal urine flow rate was greater (p<0.001) with ThuVaRP than with TURP. The postoperative complication transient urinary incontinence was significantly different between the ThuVaRP group (nine cases, 20.9%) and the TURP group (two cases, 4.7%). Other complications were comparable between groups. CONCLUSIONS: The effectiveness and safety of ThuVaRP and TURP were comparable. ThuVaRP is a promising alternative surgical technique to TURP for BPH.


Subject(s)
Humans , Catheterization , Catheters , Laser Therapy , Length of Stay , Medical Records , Postoperative Complications , Prostate , Prostate-Specific Antigen , Prostatic Hyperplasia , Residual Volume , Retrospective Studies , Thulium , Transurethral Resection of Prostate , Ultrasonography , Urinary Incontinence
12.
National Journal of Andrology ; (12): 431-434, 2011.
Article in Chinese | WPRIM | ID: wpr-305814

ABSTRACT

<p><b>OBJECTIVE</b>To compare the effects of greenlight photoselective vaporization prostatectomy (PVP) and thulium laser vaporesection of the prostate (TmLRP) in the treatment of aged high-risk BPH patients with the prostate weighing > 80 g.</p><p><b>METHODS</b>We included in this study 118 high-risk BPH patients aged 62-96 (mean 76) years with the prostate heavier than 80 g, 82 treated by PVP and the other 36 by TmLRP. Then we compared the operation time, intraoperative bleeding, complications, short-term effectiveness, and surgical cost between the two groups.</p><p><b>RESULTS</b>All the patients tided over the perioperative period without blood transfusion and serious complications. The mean operation time, postoperative bladder irrigation time and surgical cost were significantly less in the TmLRP than in the PVP group (P < 0.05). Both the procedures remarkably improved the international prostatic symptom score (IPSS), quality of life (QOL), post void residual urine (PVR) and Qmax of the patients (P < 0.05), but with no significant differences between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Both PVP and TmLRP are effective and safe for the treatment of aged high-risk BPH patients with the prostate heavier than 80 g, but the latter is superior for its shorter operation time and lower surgical cost.</p>


Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Laser Therapy , Methods , Prostatic Hyperplasia , General Surgery , Thulium , Therapeutic Uses , Transurethral Resection of Prostate , Methods , Treatment Outcome , Volatilization
13.
National Journal of Andrology ; (12): 832-834, 2011.
Article in Chinese | WPRIM | ID: wpr-305779

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the effect of endourethrotomy with thulium laser as a minimally invasive treatment for urethral stricture.</p><p><b>METHODS</b>We treated 36 cases of urethral stricture or atresia by endourethrotomy with thulium laser, restored the urethral continuity by vaporization excision of the scar tissue, and observed the clinical effects and complications.</p><p><b>RESULTS</b>The mean operation time was 35 min, ranging from 10 to 90 min. Smooth urination was achieved after 2-6 weeks of catheter indwelling, with no urinary incontinence. The patients were followed up for 4-24 (mean 12) months, during which 27 did not need any reintervention, 5 developed urinary thinning but cured by urethral dilation, 3 received another laser urethrotomy for previous negligence of timely urethral dilation, and the other 1 underwent open urethroplasty.</p><p><b>CONCLUSION</b>Thulium laser urethrotomy is a safe and effective minimally invasive option for short urethral stricture, which is also suitable for severe urethral stricture and urethral atresia. Its short-term outcome is satisfactory, but its long-term effect remains to be further observed.</p>


Subject(s)
Adult , Humans , Male , Middle Aged , Young Adult , Laser Therapy , Thulium , Therapeutic Uses , Treatment Outcome , Ureteroscopy , Urethral Stricture , General Surgery
14.
National Journal of Andrology ; (12): 346-349, 2009.
Article in Chinese | WPRIM | ID: wpr-292373

ABSTRACT

<p><b>OBJECTIVE</b>To investigate and compare the effect and safety of Holmium laser and Thulium laser in transurethral enucleation of the prostate in BPH patients.</p><p><b>METHODS</b>Ninety-eight BPH patients were divided into 2 groups and underwent transurethral enucleation of the prostate with holmium laser (Ho group) and thulium laser (Th group) respectively. Comparisons were made between the 2 groups in operation time, bleeding volume, electrolyte, IPSS score, PVR and Qmax.</p><p><b>RESULTS</b>No statistically significant differences were noted between the 2 groups in age and preoperative prostate volume, IPSS, PVR and Qmax (P > 0.05). The mean operation time was shorter in the Th group ([84.6 +/- 10.2] min) than in the Ho group ([70.5 +/- 7.5] min) (P = 0.032); blood loss was less in the former ([126.5 +/- 14.6] ml) than in the latter ([176.5 +/- 14.1] ml) (P = 0.071), with no blood transfusion necessitated; and the mean times of catheter indwelling were 2.4 d and 2.5 d respectively. There were no significant differences in the levels of hemoglobin and electrolyte before and after operation between the two groups, and no TURP syndrome was observed. IPSS, PVR and Qmax before operation were significantly different from those obtained 3 months after it (P < 0.05) in both the groups, but none of the indexes exhibited statistically significant differences when compared in the same period (P > 0.05).</p><p><b>CONCLUSION</b>Both holmium and thulium laser transurethral enucleation of the prostate can alleviate LUTS in BPH patients with similar short-time effectiveness. Thulium is superior to holmium laser in hemostasis, but inferior to it in anatomical distinctness.</p>


Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Lasers, Solid-State , Therapeutic Uses , Prostatic Hyperplasia , General Surgery , Thulium , Therapeutic Uses , Transurethral Resection of Prostate , Methods , Treatment Outcome
15.
Asian Journal of Andrology ; (6): 277-281, 2009.
Article in English | WPRIM | ID: wpr-284671

ABSTRACT

Two-micron (thulium) laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. We recently reported the primary results. Here we introduce this procedure in detail. A 70-W, 2-microm (thulium) laser was used in continuous-wave mode. We joined the incision by making a transverse cut from the level of the verumontanum to the bladder neck, making the resection sufficiently deep to reach the surgical capsule, and resected the prostate into small pieces, just like peeling a tangerine. As we resected the prostate, the pieces were vaporized, sufficiently small to be evacuated through the resectoscope sheath, and the use of the mechanical tissue morcellator was not required. The excellent hemostasis of the thulium laser ensured the safety of TmLRP-TT. No patient required blood transfusion. Saline irrigation was used intraoperatively, and no case of transurethral resection syndrome was observed. The bladder outlet obstruction had clearly resolved after catheter removal in all cases. We designed the tangerine technique and proved it to be the most suitable procedure for the use of thulium laser in the treatment of benign prostatic hyperplasia (BPH). This procedure, which takes less operative time than standard techniques, is safe and combines efficient cutting and rapid organic vaporization, thereby showing the great superiority of the thulium fiber laser in the treatment of BPH. It has been proven to be as safe and efficient as transurethral resection of the prostate (TURP) during the 1-year follow-up.


Subject(s)
Humans , Male , Follow-Up Studies , Laser Therapy , Methods , Lasers , Postoperative Care , Methods , Prostatectomy , Methods , Prostatic Hyperplasia , General Surgery , Thulium , Videotape Recording
16.
African Journal of Urology. 2008; 14 (1): 1-14
in English | IMEMR | ID: emr-135084

ABSTRACT

This review presents an overview of the current state of the art of laser prostatic surgery. Several types of lasers have been used in the treatment of benign prostatic hyperplasia [BPH] over the past 15 years. Vaporization techniques have recently gained popularity and have been widely accepted by many urologists. Short-term results show that vaporization of a prostatic adenoma with higher-power potassium titanyl phosphate and holmium lasers is safe and effective in the treatment of symptomatic BPH. However, well designed randomized comparative trials with long-term follow-up are still needed. Holmium laser is a multi-purpose surgical tool and has multiple applications in urology. In the treatment of symptomatic BPH, holmium laser can be used in ablation, resection and enucleation of the prostate. Holmium laser enucleation of the prostate [HoLEP] is the most investigated laser procedure used in the treatment of symptomatic BPH. Several randomized controlled trails confi rmed the safety, efficacy, and durability of HoLEP regardless of the prostate size


Subject(s)
Humans , Male , Laser Therapy , Prostatic Hyperplasia/surgery , Prostatectomy , Holmium , Lasers, Solid-State , Transurethral Resection of Prostate , Urinary Retention , Cost-Benefit Analysis , Thulium
17.
Egyptian Journal of Chemistry. 1999; 42 (1): 37-47
in English | IMEMR | ID: emr-107873

ABSTRACT

The complexes of Tm [III] and UO2 [VI] with 8-[arylazo] -6,7-dihydroxy-4-methylcoumarin derivatives were investigated spectrophotometrically. The optimum conditions for chelation, pH, sequence of addition, time, solvents and stoichiometry were critically evaluated. The studies revealed that 1: 1 and 1: 2 [M: L] complexes were formed. The higher stability constants for Tm [III] complexes compared to those of UO2+ 2 complexes were explained in terms of the hydrolysis, steric effect and nature of bonding of both metal ions. Beer's Law was valid up to 16.89 mug/cm3 for Tm3+ complexes and 23.28 mug/cm3 for UO2+ 2 complexes. Spectrophotometric methods for the determination of Tm [III] and UO2+ 2 were presented. The methods were precise as shown by low standard deviations ranging from 0.0011 to 0.0146 and high correlation coefficient [r] ranging from 0.9965 to 0.9994. The values of molar absorptivity, epsilon [LM-1 cm-1] specific absorptivity, a [ml g-1 cm-1] and Sandell sensitivity and S [mug cm-1] indicated the method to be quite sensitive compared to recommended methods using arsenazo I and thoron. A photometric titration method using EDTA as titrant was given


Subject(s)
Thulium/analysis , Uranium Compounds/chemistry , Uranium Compounds/analysis , Spectrophotometry , Coumarins/chemistry , Coumarins/analogs & derivatives
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