V3-13 THULIUM VAPOENUCLEATION OF THE PROSTATE: SURGICAL TECHNIQUE FROM VAPORIZATION TO VAPOENUCLEATION

Abstract

You have accessJournal of UrologyMale Voiding/Sexual Dysfunction/BPH/ Incontinence/Infection/Infertility1 Apr 2015V3-13 THULIUM VAPOENUCLEATION OF THE PROSTATE: SURGICAL TECHNIQUE FROM VAPORIZATION TO VAPOENUCLEATION David Leavitt, Christian Tiburtius, Christopher Netsch, Zeph Okeke, Thomas Herrmann, Arthur Smith, and Andreas Gross David LeavittDavid Leavitt More articles by this author , Christian TiburtiusChristian Tiburtius More articles by this author , Christopher NetschChristopher Netsch More articles by this author , Zeph OkekeZeph Okeke More articles by this author , Thomas HerrmannThomas Herrmann More articles by this author , Arthur SmithArthur Smith More articles by this author , and Andreas GrossAndreas Gross More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1354AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Thulium vapoenucleation of the prostate (ThuVEP) is a minimally invasive, size-independent transurethral procedure for symptomatic benign prostatic enlargement (BPE). We have shown ThuVEP may be safely applied to almost all patients, and provides results similar to open prostatectomy and transurethral resection of the prostate. The aim of this video is to teach the steps necessary to execute ThuVEP safely. METHODS In this educational video we detail our surgical technique for ThuVEP and include advice on how to avoid complications. We emphasize a tested, systematic surgical learning algorithm beginning with vaporization, advancing to vaporesection, and ultimately progressing to vapoenulceation. RESULTS Our prior work has shown that by following the presented learning algorithm, proficiency at ThuVEP is attainable after 15 mentored-assisted cases, and even applies to urology residents with limited prior transurethral experience. In a review of 1080 patients undergoing ThuVEP between 2007 and 2012, median prostate volume was 51 ml (36 – 79 ml) with 25% of the prostate volumes larger than 80 ml, median enucleation time was 32.5 minutes (22 – 50 min), median total operation time was 56 minutes (40 – 80 min), Clavien 3 or higher complications occurred in 72 (6.7%) patients, and 18 (1.7%) patients received a blood transfusion. CONCLUSIONS The learning algorithm presented for ThuVEP is safe and effective, and allows the trainee to gain surgical proficiency in a reasonable timeframe. Once surgical proficiency is achieved, ThuVEP should be considered a viable treatment option in all patients with symptomatic BPE, including those on anticoagulation and those with massive prostates. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e338-e339 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Leavitt More articles by this author Christian Tiburtius More articles by this author Christopher Netsch More articles by this author Zeph Okeke More articles by this author Thomas Herrmann More articles by this author Arthur Smith More articles by this author Andreas Gross More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...