Treatment outcomes of benign prostate hyperplasia by thulium vapoenucleation of the prostate in aging men

Abstract

PurposeTo analyze the outcomes of thulium vapoenucleation of the prostate (ThuVEP) in the management of benign prostatic hyperplasia. The outcomes of this increasingly popular procedure are yet to be confirmed in patients with various prostate sizes and health status. Materials and methodsThree hundred and three patients who underwent ThuVEP were included and stratified in subgroups according to prostate size and age. We analyzed patient demographics, preoperative disease-related parameters, and perioperative and follow-up results. Correlation of prostate size and operation time were also assessed. ResultsBaseline mean prostate volume was 61.0 mL (range 19.3–226 mL), mean urinary peak flow rate (Qmax) was 8.6 mL/second (range 1.4–23.25 mL/second), mean postvoid residual volume was 126.2 mL (range 0–649 mL) and mean International Prostate Symptom Score was 25.1 (range 8–35). The mean operation time was 84.0 minutes and 88.6 minutes for total and prostate volume >80 mL, respectively. After laser surgery, there were mean reductions of 5.3 ng/mL, 7.5 ng/mL, 3.7 ng/mL, and 3.5 ng/mL (38.0%, 49.7%, 30.3%, and 36.5% change from baseline) in prostate-specific antigen level among the four groups. As for postvoid residual volume, there was a significant reduction in volume in the total, prostate volume >80 mL and prostate volume <80 mL (−73.9 mL, −70.8 mL, and −67 mL, respectively) but not in the elderly group (−31.4 mL, p = 0.068). Similarly, Qmax improved significantly in all (6.7 mL/second, 5.9 mL/second, and 6.0 mL/second, respectively) except the elderly group (2.3 mL/second, p = 0.103). The operation time was highly correlated with the prostate size. ConclusionThis study indicates that ThuVEP is an effective treatment option for benign prostatic obstruction in patients with different prostate size and age. The technique allows an efficient surgical course with operation time highly correlated with prostate size.