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Thulium laser enucleation of prostate versus laparoscopic trans-vesical simple prostatectomy in the treatment of large benign prostatic hyperplasia: head-to-head comparison
Bertolo, Riccardo; Dalpiaz, Orietta; Bozzini, Giorgio; Cipriani, Chiara; Vittori, Matteo; Alber, Thomas; Maiorino, Francesco; Carilli, Marco; Zeder, Robin; Iacovelli, Valerio; Antonucci, Michele; Sandri, Marco; Bove, Pierluigi.
  • Bertolo, Riccardo; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
  • Dalpiaz, Orietta; LKH Hochsteiermark. Department of Urology. Leoben. AT
  • Bozzini, Giorgio; ASST Valle Olona. Department of Urology. Busto Arsizio. IT
  • Cipriani, Chiara; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
  • Vittori, Matteo; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
  • Alber, Thomas; LKH Hochsteiermark. Department of Urology. Leoben. AT
  • Maiorino, Francesco; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
  • Carilli, Marco; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
  • Zeder, Robin; LKH Hochsteiermark. Department of Urology. Leoben. AT
  • Iacovelli, Valerio; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
  • Antonucci, Michele; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
  • Sandri, Marco; University of Brescia. Big & Open Data Innovation Laboratory. IT
  • Bove, Pierluigi; San Carlo di Nancy Hospital. Department of Urology. Rome. IT
Int. braz. j. urol ; 48(2): 328-335, March-Apr. 2022. tab
Article in English | LILACS | ID: biblio-1364937
Responsible library: BR1.1
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)


Full text: Available Index: LILACS (Americas) Main subject: Prostatic Hyperplasia / Laparoscopy / Laser Therapy / Lasers, Solid-State Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2022 Type: Article Affiliation country: Austria / Italy Institution/Affiliation country: ASST Valle Olona/IT / LKH Hochsteiermark/AT / San Carlo di Nancy Hospital/IT / University of Brescia/IT

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Full text: Available Index: LILACS (Americas) Main subject: Prostatic Hyperplasia / Laparoscopy / Laser Therapy / Lasers, Solid-State Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2022 Type: Article Affiliation country: Austria / Italy Institution/Affiliation country: ASST Valle Olona/IT / LKH Hochsteiermark/AT / San Carlo di Nancy Hospital/IT / University of Brescia/IT