2176 PROSPECTIVE EVALUATION OF THULIUM LASER ENUCLEATION IN LARGE PROSTATES LARGER THAN 80CC

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology (III)1 Apr 20132176 PROSPECTIVE EVALUATION OF THULIUM LASER ENUCLEATION IN LARGE PROSTATES LARGER THAN 80CC Gunnar Wendt-Nordahl, David Zimmermann, Patrick Honeck, and Thomas Knoll Gunnar Wendt-NordahlGunnar Wendt-Nordahl Sindelfingen, Germany More articles by this author , David ZimmermannDavid Zimmermann Sindelfingen, Germany More articles by this author , Patrick HoneckPatrick Honeck Sindelfingen, Germany More articles by this author , and Thomas KnollThomas Knoll Sindelfingen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2085AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Traditionally, open simple prostatectomy is recommended for surgical therapy of benign prostatic enlargement in prostates larger than 80-100cc. However, laser enucleation using Holmium or Thulium laser devices have been introduced as a minimally invasive alternative in recent years. We report our experience with Thulium laser enucleation of the prostate in large prostates. METHODS A prospective evaluation of 82 patients with prostates larger than 80cc undergoing Thulium laser enucleation between 7/2010 and 10/2012 was performed. All patients were operated by a single surgeon and the results include his learning curve. RESULTS Mean patient age was 73±8years, mean prostate volume was 122±53cc (80-400cc) preoperatively. 42 patients (51%) presented in urinary retention, the others displayed a max. flow rate of 9.9±5.2ml/s and a post void residual volume (PVR) of 91±155ml preoperatively. In a mean operation time of 108±49min a total of 63±31g tissue was enucleated. After removal of the Foley catheter 72 patients (88%) voided satisfactorily and displayed a max. flow rate of 13.4±6.2ml/s and a PVR of 39±61ml. 9 patients (11%) displayed high PVRs and were discharged with a suprapubic catheter. Early complications included bleeding requiring coagulation or transfusion in 7, fever in 6, temporary re-catheterization in 2, °I-II stress incontinence in 2, postoperative hydronephrosis in 2 and urge symptoms in 2 patients. Mean catheter time was 2.7 ±1.1days and hospital stay was 5.7 ± 3.6 days. CONCLUSIONS Thulium laser enucleation of the prostate is a safe and efficient minimal invasive treatment alternative for patients with large prostates. Despite a not deniable risk for bleeding complications, the associated treatment morbidity seems decisively lower in comparison to open simple prostatectomy even if the learning curve is included. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e892-e893 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gunnar Wendt-Nordahl Sindelfingen, Germany More articles by this author David Zimmermann Sindelfingen, Germany More articles by this author Patrick Honeck Sindelfingen, Germany More articles by this author Thomas Knoll Sindelfingen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...