Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases

Objectives: To report our experience with the emerging technique of thulium laser enucleation of the prostate (ThuLEP) for the treatment for prostate hyperplasia. Patients and methods: Our inclusion criteria were an International Prostate Symptom Score (IPSS) of >15 and a quality-of-life (QoL) sc...

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Autores principales:	Marco Raber, Noor N.P. Buchholz, Augusto Vercesi, Nashaat A. Hendawi, Vincenzo Inneo, Giuseppe Di Paola, Lorenzo Tessa, Ismail M. Hassan
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2018
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/f5a14f77cf5d4dcdbf44bc3bbb3cb09b
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spelling	oai:doaj.org-article:f5a14f77cf5d4dcdbf44bc3bbb3cb09b2021-12-02T13:03:31ZThulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases2090-598X10.1016/j.aju.2018.05.004https://doaj.org/article/f5a14f77cf5d4dcdbf44bc3bbb3cb09b2018-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X18300603https://doaj.org/toc/2090-598XObjectives: To report our experience with the emerging technique of thulium laser enucleation of the prostate (ThuLEP) for the treatment for prostate hyperplasia. Patients and methods: Our inclusion criteria were an International Prostate Symptom Score (IPSS) of >15 and a quality-of-life (QoL) score of >3 in patients with confirmed bladder outflow obstruction, no longer responsive to medical therapy, with a significant post-void residual urine volume (PVR; >100 mL), with or without recurrent urinary tract infection and/or acute urinary retention. Patients with neurogenic bladder, urethral strictures, bladder stones, and previously failed transurethral prostate surgery were excluded. Results: In all, 139 men were included in the study. The mean age was 67.8 years. The IPSS and QoL score improved by 17.6 and 2.6, respectively. The flow rate increased from a mean of 9.6 mL to 31.2 mL and the PVR decreased from a mean of 131 mL to 30 mL. On univariate and multivariate analyses, operating time was a predictive factor for haemoglobin drop during the operation. Heparin prophylaxis was the only risk factor identified for postoperative bleeding. Two patients (0.01%) required blood transfusion. One patient (0.007%) required re-intervention for bleeding control, and two patients developed urethral and bladder neck strictures (0.01%). Conclusion: ThuLEP is safe and reproducible. Whilst it significantly reduces intraoperative bleeding as compared to transurethral resection of the prostate, operating time and perioperative heparin prophylaxis may still lead to a Hb drop and constitute a risk factor for postoperative bleeding. Therefore, a potential risk of deep vein thrombosis requiring heparin prophylaxis should be carefully considered and balanced with the expected clinical benefit of the operation. Keywords: Prostate enlargement, Thulium laser, Endoscopy, TreatmentMarco RaberNoor N.P. BuchholzAugusto VercesiNashaat A. HendawiVincenzo InneoGiuseppe Di PaolaLorenzo TessaIsmail M. HassanTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss 4, Pp 411-416 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Marco Raber Noor N.P. Buchholz Augusto Vercesi Nashaat A. Hendawi Vincenzo Inneo Giuseppe Di Paola Lorenzo Tessa Ismail M. Hassan Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases
description	Objectives: To report our experience with the emerging technique of thulium laser enucleation of the prostate (ThuLEP) for the treatment for prostate hyperplasia. Patients and methods: Our inclusion criteria were an International Prostate Symptom Score (IPSS) of >15 and a quality-of-life (QoL) score of >3 in patients with confirmed bladder outflow obstruction, no longer responsive to medical therapy, with a significant post-void residual urine volume (PVR; >100 mL), with or without recurrent urinary tract infection and/or acute urinary retention. Patients with neurogenic bladder, urethral strictures, bladder stones, and previously failed transurethral prostate surgery were excluded. Results: In all, 139 men were included in the study. The mean age was 67.8 years. The IPSS and QoL score improved by 17.6 and 2.6, respectively. The flow rate increased from a mean of 9.6 mL to 31.2 mL and the PVR decreased from a mean of 131 mL to 30 mL. On univariate and multivariate analyses, operating time was a predictive factor for haemoglobin drop during the operation. Heparin prophylaxis was the only risk factor identified for postoperative bleeding. Two patients (0.01%) required blood transfusion. One patient (0.007%) required re-intervention for bleeding control, and two patients developed urethral and bladder neck strictures (0.01%). Conclusion: ThuLEP is safe and reproducible. Whilst it significantly reduces intraoperative bleeding as compared to transurethral resection of the prostate, operating time and perioperative heparin prophylaxis may still lead to a Hb drop and constitute a risk factor for postoperative bleeding. Therefore, a potential risk of deep vein thrombosis requiring heparin prophylaxis should be carefully considered and balanced with the expected clinical benefit of the operation. Keywords: Prostate enlargement, Thulium laser, Endoscopy, Treatment
format	article
author	Marco Raber Noor N.P. Buchholz Augusto Vercesi Nashaat A. Hendawi Vincenzo Inneo Giuseppe Di Paola Lorenzo Tessa Ismail M. Hassan
author_facet	Marco Raber Noor N.P. Buchholz Augusto Vercesi Nashaat A. Hendawi Vincenzo Inneo Giuseppe Di Paola Lorenzo Tessa Ismail M. Hassan
author_sort	Marco Raber
title	Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases
title_short	Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases
title_full	Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases
title_fullStr	Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases
title_full_unstemmed	Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases
title_sort	thulium laser enucleation of the prostate (thulep): results, complications, and risk factors in 139 consecutive cases
publisher	Taylor & Francis Group
publishDate	2018
url	https://doaj.org/article/f5a14f77cf5d4dcdbf44bc3bbb3cb09b
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Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases

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