Thulium Laser Enucleation Research Articles

A0878 - Evaluation of the learning curve for Thulium laser enucleation of the prostate using multiple outcome measures

A0878 - Evaluation of the learning curve for Thulium laser enucleation of the prostate using multiple outcome measures

Long-term Reinterventions after Thulium Laser Enucleation of the Prostate: 12-Year Experience with more than 1000 Patients

BackgroundThulium laser enucleation of the prostate (ThuLEP) is an established treatment option for benign prostatic enlargement (BPE), but long-term outcomes have not yet been reported. ObjectiveTo prove the durability of ThuLEP by investigating its long-term efficacy and morbidity. Design, setting, and participantsAll patients who underwent ThuLEP at a German tertiary referral center between 2009 and 2021 were retrospectively followed up for reinterventions for persistence or regrowth of prostate adenoma (ReIP) or long-term complications (ReIC). InterventionThuLEP. Outcome measurements and statistical analysisWe calculated the cumulative incidence for ReIP and ReIC at 10 yr. Univariate and multivariate Cox regression models were constructed to identify predictors of ReIP and ReIC. Results and limitationsOverall, 1097 patients underwent ThuLEP. The median overall follow-up was 6.0 yr (interquartile range [IQR] 2.4–9.2). For one-third of patients (n = 369), median follow-up of 10 yr (IQR 9.1–11.2) was available. A total of 42 patients (3.8%) underwent ReIP after a median of 2 yr (IQR 0.3–4.9). The rate of long-term ReIC was 2.6% (n = 29) and the median time to ReIC was 0.5 yr (IQR 0.3–1.7). The most frequent ReIC was urethrotomy (n = 16, 1.5%). The cumulative incidence of ReIP and ReIC at 10 yr was estimated at 5.6% and 3.4%, respectively. Enucleation weight ≥60 g was a significant predictor of ReIP (hazard ratio 1.2, p = 0.014). The retrospective study design and the lack of functional outcomes are the main limitations. ConclusionsThuLEP is a durably effective and safe procedure with low reintervention rates within 12 yr. Patient summaryThis study investigated long-term outcomes of thulium laser enucleation of the prostate for benign enlargement of the prostate (BPE). Low rates of repeat treatment for BPE recurrence or for other complications were observed. Our results show the safety and efficacy of this treatment over a period of 12 years.

Learning curve of ThuLEP (Thulium laser enucleation of the prostate): Single-centre experience on initial consecutive 60 patients.

Benign prostatic hyperplasia (BPH) is a common problem among elderly men. Recently, laser prostate enucleations have gained popularity with successful results; however, it requires steep learning curves. The initial 60 cases of ThuLEP performed at our centre were retrospectively enrolled. A 200W CyberTM Thulium laser (Quanta System, Italy) with 550µm fibre was used, and a single surgeon highly experienced with transurethral resection performed all procedures. Patients were divided into three consecutive groups. Preoperative variables such as prostate volume, prostate-specific antigen and haemoglobin levels, International Prostate Symptom Score (IPSS), International Index of Erectile Function scores and uroflowmetry parameters were all noted. The enucleated tissue weight, enucleation and morcellation times with efficiencies, hospitalization and catheterization times were calculated. Perioperative complications were also observed. The postoperative 6th month uroflowmetry parameters were evaluated and compared with prior ones. Morcellation and enucleation efficiencies, hospitalization and catheterization times, postoperative IPSS were significantly different between the groups. Complications were also compared between the groups, and only short-term perioperative complications were encountered. We aimed to evaluate initial cases of ThuLEP to provide information for beginners with management of early term possible complications. The learning curve for ThuLEP could be handled after exceeding 20 initial cases.

Prostate-Specific Antigen Velocity Predicts Surgical Outcome of Thulium Laser Enucleation of the Prostate.

Background: We determined the effect of prostate-specific antigen velocity (PSAV) on the surgical outcome of thulium laser enucleation of the prostate (ThuLEP) in patients with benign prostatic hyperplasia (BPH).Methods: A retrospective review was performed of prospectively collected data of patients with BPH who underwent ThuLEP at any time from 2017 to 2019. Patients who had undergone BPH surgery or had prostate cancer previously were excluded, and patients with prostate-specific antigen (PSA) > 4 ng/ml were examined through transrectal ultrasound-guided prostate biopsy to rule out prostatic malignancy. Furthermore, patients were excluded if prostatic malignancy was diagnosed during postsurgery follow-up.Results: The PSA level, International Prostate Symptom Score (IPSS), and quality of life (QoL) of 27 male patients at 3 and 15 months postsurgery differed significantly from those at presurgery; the maximum flow rate (Qmax) and postvoid residual (PVR) significantly differed between 3 months postsurgery and presurgery; and 22 and 5 patients had good to excellent and fair to poor outcomes, respectively, at 15 months postsurgery. Patients were divided into two groups (fair and poor vs. good and excellent outcomes at 15 months postsurgery), which significantly differed with respect to PSAV at 3 months postsurgery (P = 0.04), IPSS presurgery (P < 0.02), surgical length (P = 0.01), and hospitalization duration (P = 0.04). In a receiver operating characteristic (ROC) analysis, the optimal cutoff value of PSAV of −0.52 ng/ml characterized effectiveness at 15 months after ThuLEP, and the area under the curve (AUC), sensitivity, and specificity were 0.82 (P < 0.02), 0.80, and 0.82, respectively. For PSAV < -0.52 and ≥-0.52 ng/ml, the percentages of reduction for IPSS, QoL, Qmax, and PVR were −78.6 and −71.4%, −33.3 and 0.0%, 94.4 and 40.0%, and −85.1 and −38.7%, respectively.Conclusions: Postsurgical PSAV was positively correlated with surgical success, and the PSAV cutoff was −0.52 ng/ml. PSAV can, thus, be used to guide the postsurgical follow-up treatment at 3 months after BPH surgery.

Thulium laser enucleation of prostate: Novel therapy for benign prostatic hyperplasia

Background: Transurethral resection of the prostate (TURP) has been the undisputed gold standard treatment for benign prostatic enlargement (BPE). However, morbidity after TURP remains significant with increased risk of bleeding and TUR syndrome. In recent years, the role of laser technology in endoscopic prostatic surgery has gradually increased. In our study, we evaluate the efficacy and safety of a novel technique of Thulium laser enucleation of prostate (THULEP) in the treatment of BPE.Materials and Methods: Five hundred and thirty-six patients with symptomatic benign prostatic hyperplasia (BPH) were treated with THULEP. The inclusion criteria were acute retention of urine with the failure of trial without catheter, dissatisfaction with medical treatment, maximum urinary flow rate (Qmax) <15 ml/s, and International Prostate Symptoms Score (IPSS) >15. Patients were evaluated by Digital rectal examination (DRE), uroflowmetry, IPSS, prostate-specific antigen (PSA), blood and urine routine tests, abdominal ultrasonography, and trans-rectal ultrasonography (TRUS).Results: The efficacy of THULEP was assessed by comparing preoperative variables with postoperative data. IPSS score got reduced from 24 to 3.5, quality of life score improved to 0–1 from 4–5. Qmax improved from mean 7 to 20 ml/s, Postvoid residue reduced from a mean of 110 to 12 ml. Hospital stay was < 36 h in the majority of patients. The average operative time was 45 min. No postoperative blood transfusion was required.Conclusion: THULEP is a safe procedure and has a lesser number of complications. THULEP can replace monopolar TURP as a gold standard for the treatment of BPH.

Complications and functional outcomes of endoscopic enucleation of the prostate: a systematic review and meta-analysis of randomised-controlled studies.

There are several endoscopic enucleation procedures (EEP) using different energy sources: holmium laser enucleation of the prostate (HoLEP), thulium laser enucleation of the prostate (ThuLEP), Greenlight® (GreenVEP) and diode (DiLEP) lasers, and plasma kinetic enucleation of the prostate (PKEP). The comparative outcomes among these EEPs are unclear. We aimed to compare the peri-operative and post-operative outcomes, complications and functional outcomes among different EEPs. A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. Only randomised-controlled trials (RCT) comparing EEPs were included. The risk of bias was assessed using the Cochrane tool for RCTs. The search identified 1153 articles and 12 RCTs were included. The number of RCTs for each comparison was, HoLEP vs ThuLEP; n = 3, HoLEP vs PKEP; n = 3, PKEP vs DiLEP; n = 3, HoLEP vs GreenVEP; n = 1, HoLEP vs DiLEP; n = 1, ThuLEP vs PKEP; n = 1. Operative time was shorter and blood loss was lower with ThuLEP compared with HoLEP, whereas operative time was shorter for HoLEP compared with PKEP. Blood loss was lower with HoLEP and DiLEP compared with PKEP. There were no Clavien-Dindo IV-V complications, and the incidence of Clavien-Dindo I complications was lower with ThuLEP compared with HoLEP. No significant differences were detected among EEPs regarding urinary retention, stress urinary incontinence, bladder neck contracture or urethral stricture. Lower International Prostate Symptom Score (IPSS) and higher quality of life (QoL) scores were in favour of ThuLEP compared with HoLEP at 1 month. EEP improves symptoms and uroflowmetry parameters with a low incidence of high-grade complications. ThuLEP was associated with shorter operative time, lower blood loss, and lower incidence of low-grade complications compared with HoLEP.

Safety and Efficacy of Laser Enucleation of the Prostate in Elderly Patients - A Narrative Review.

Benign prostatic hyperplasia (BPH) is a common health condition in aging men resulting in lower urinary tract symptoms (LUTS) and low quality of life (QoL). We aimed to review studies on laser enucleation of the prostate (LEP) due to LUTS in elderly patients (>65 years) comparing different age groups, particularly considering functional outcomes, safety, and perioperative complications. A comprehensive search was conducted using the PubMed-MEDLINE, Web of Science, Wiley Online Library and Cochrane Library databases over the last 10 years until 7 October 2021 with the following search terms solely or in combination: “laser enucleation”, “prostate”, “laser prostatectomy”, “aging”, “elderly patients”, “older patients” and “age”. We identified 12 articles for inclusion in our analysis. Five studies focussed mainly on holmium laser enucleation of the prostate (HoLEP), one compared HoLEP to other laser prostatectomy procedures, two studies examined thulium laser enucleation of the prostate (ThuLEP), and two studies focused on GreenLight laser, one study focussed on potassium-titanyl-phosphate (KTP) laser, and another study compared laser prostatectomy to transurethral resection of the prostate (TURP). These studies showed that LEP improved IPSS, Qmax and QoL compared to baseline regardless of age; no significant difference was reported among age groups. Although ASA scores and anticoagulation/antiplatelet therapy rates are higher in elderly patients, studies revealed no significant difference in perioperative complication rates between age groups. Laser enucleation of the prostate is an effective and safe procedure in elderly patients, resulting in good functional outcomes, low morbidity, and few perioperative complications.

Current evidence of ThuLEP for BPH: A review of literature.

Endoscopic enucleation of the prostate (EEP) techniques for the treatment of benign prostatic hyperplasia (BPH) have become increasingly popular among urologists over the past 23 years. Despite the energy source employed, the aim of all these procedures is to endoscopically remove the prostatic lobes by enucleating them from the prostate surgical capsule. The reasons for which EEP has gained popularity among urologists are the reduction in complications and hospital stay compared to endoscopic gold standard Transurethral Resection of the Prostate (TURP), but especially the possibility to treat large prostates, allowing to abandon open simple prostatectomy (OP) and to avoid the burden related to open surgery. Holmium laser enucleation of the prostate (HoLEP) sets the basic principles of all EEP techniques in 1998 and has become the treatment of reference for BPH. Since then, various lasers have been developed and applied to prostatic enucleation. The thulium laser has a slightly shorter wavelength compared to the holmium laser and a continuous wave output, which increase vaporization and reduce penetration depth. These features make it ideal for prostatic enucleation. A vapoenucleating technique called Thulium Laser Vapoenucleation of the Prostate was presented in 2009, followed by a blunt enucleating technique called Thulium Laser Enucleation of the Prostate in 2010. These techniques have become alternatives to HoLEP and TURP; however, the amount of literature and randomized controlled trials available are inferior compared to HoLEP. The aim of th describe, and discuss current evidence on thulium enucleating techniques.

Comparison on the Efficacy and Safety of Different Surgical Treatments for Benign Prostatic Hyperplasia With Volume >60 mL: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials.

The objective of this study was to compare the efficacy and safety of 10 different surgical treatments for benign prostatic hyperplasia (BPH) with volume >60 mL. A systematic literature review and network meta-analysis of randomized controlled trials (RCTs) within a Bayesian framework was performed. A total of 52 parallel-group RCTs included, reporting on 6,947 participants, comparing open prostatectomy (OP), monopolar/bipolar transurethral resection of prostate (monopolar/ bipolar TURP), thulium, holmium and diode laser enucleation of prostate (LEP), bipolar enucleation of prostate, potassium titanyl phosphate laser vaporization of prostate (KTP LVP), bipolar vaporization of prostate (bipolar VP), and laparoscopic simple prostatectomy (laparoscope SP). Compared with OP, laparoscope SP identified better maximal flow rate (Qmax; mean differences [MDs] = 2.89 mL/s) at the 24th month, but bipolar VP demonstrated worse Qmax (MD = −3.20 mL/s) and International Prostate Symptom Score (IPSS; MD = 2.60) at the 12th month. Holmium LEP (MD = 1.37) demonstrated better International Index of Erectile Function–5 at the 12th month compared with OP. However, compared with OP, KTP LVP demonstrated worse postvoid residual volume (PVR) at the sixth (MD = 10.42 mL) and 12th month (MD = 5.89 mL) and monopolar TURP (MD = 6.9 mL) demonstrated worse PVR at the 12th month. Eight new surgical methods for BPH with volume >60 mL appeared to be superior in safety compared with OP and monopolar TURP due to fewer complications. Bipolar VP and KTP LVP maybe not suitable for prostates more than 60 mL due to short- and middle-term worse Qmax, IPSS, and PVR than OP.

Complications from normal saline in thulium laser enucleation of the prostate

Systemic fluid absorption frequently occurs during endoscopic prostatic surgery. The introduction of lasers allowed the use of normal saline (0.9% sodium chloride). We report 2patients who developed hyperchloremic metabolic acidosis and isotonic hypervolemia during thulium laser enucleation of the prostate (ThuLEP) and required prolonged ventilation time, catecholamines, intensive care and prolonged hospitalization. Achange to balanced electrolyte solutions in urology-as is already established in infusion and volume therapy-would be desirable, especially to avoid hyperchloremic metabolic acidosis.

SC257 - Laparoscopic partial nephrectomy with thulium laser enucleation of the tumor: perioperative and functional outcomes

SC257 - Laparoscopic partial nephrectomy with thulium laser enucleation of the tumor: perioperative and functional outcomes

PD23-03 FAILURE OF PROSTATIC URETHRAL LIFT BASED ON SUBSEQUENT MEDICAL AND/OR SURGICAL MANAGEMENT: DATA FROM A L.I.F.T. STUDY CENTER

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (PD23)1 Sep 2021PD23-03 FAILURE OF PROSTATIC URETHRAL LIFT BASED ON SUBSEQUENT MEDICAL AND/OR SURGICAL MANAGEMENT: DATA FROM A L.I.F.T. STUDY CENTER Rahul Dutta, Ethan Matz, Nicholas Deebel, Elizabeth Boes, and Ryan Terlecki Rahul DuttaRahul Dutta More articles by this author , Ethan MatzEthan Matz More articles by this author , Nicholas DeebelNicholas Deebel More articles by this author , Elizabeth BoesElizabeth Boes More articles by this author , and Ryan TerleckiRyan Terlecki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002016.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The prostatic urethral lift (PUL) is a popular surgical option for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). Prior 5-year data from the multicenter L.I.F.T. trial suggested durability and a surgical retreatment rate of 13.6%. To determine the rate of definitive correction, we sought to assess the need for ongoing medical or surgical BPH management following PUL. METHODS: With IRB approval, all cases of PUL performed from 2015-2020 at our academic center, notably a participating institution for the L.I.F.T. trial, were retrospectively reviewed. Data extracted included: demographics, medication use, symptomatology, operative details, and surgical reinterventions. RESULTS: 209 men were identified, with follow-up data available for 198 (95%). Mean age was 68.9 years (42–92) and mean follow-up was 18.5 months (0.5–66.4). Mean prostate size was 43.0 grams (8–138). Prior to PUL, significant intravesical protrusion and urethral stricture were noted cystoscopically in 22% and 8% of men, respectively. Mean procedure time was 19 minutes (2–60) and mean number of implants was 5.0 (1–10). Patients were discharged from recovery in 97% of cases, with 29% requiring indwelling or intermittent catheterization. The rate of 30-day complications was 18%, with 89% graded Clavien I or II. Postoperatively, mean improvements in International Prostate Symptom Score (IPSS) and quality of life (QOL) were 5.3 and 1.1 points, respectively. Unplanned emergency room or clinic visits occurred in 14% and 17% of men, respectively, with 4% requiring hospital readmission. Medication for LUTS attributed to BPH (α-blocker or 5α-reductase inhibitor) was continued or initiated postoperatively for 44% of men. 20% of men required repeat surgical intervention at a mean of 19.2 months (1.4–56.4), consisting of repeat PUL (30%), transurethral resection of prostate (28%), or thulium laser enucleation (18%). Overall, 53% of men needed medication and/or repeat surgery for BPH following PUL, and this was independent of age, race, prostate volume, intravesical prostate protrusion, baseline IPSS and QOL, stricture, number of implants used, or a history of urinary retention (p>0.05). CONCLUSIONS: Our data indicate that the majority of men undergoing PUL require ongoing medical and/or surgical management for BPH. Patients should be counseled as to the likelihood of failure as a unimodal therapy long-term. As this does not appear related to patient selection, the overall value of PUL to men with LUTS attributed to BPH should be carefully assessed. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e421-e421 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rahul Dutta More articles by this author Ethan Matz More articles by this author Nicholas Deebel More articles by this author Elizabeth Boes More articles by this author Ryan Terlecki More articles by this author Expand All Advertisement Loading ...

Risk Factors of Emergency Room Visits for Bleeding Complications Following Transurethral Procedures in the Treatment of Benign Prostatic Hyperplasia: A Retrospective Cohort Study.

PurposeTransurethral procedures, including transurethral resection of the prostate (TURP) and laser prostatectomy, are often linked to emergency room (ER) visits for postoperative bleeding. Although some studies have been conducted, the risk factors associated with these ER visits are not completely understood. This retrospective cohort study identified potential risk factors associated with ER visits for postoperative bleeding.Patients and MethodsPreoperative assessment data and operational and postoperational parameters recorded at Chang Gung Memorial Hospital, Taiwan between December 2015 and January 2017 for patients who underwent elective transurethral procedures were analyzed to identify potential risk factors. The primary endpoint was ER visits for gross hematuria within three months following operation, and the secondary endpoint was ER visits for blood clot-induced urinary retention (clot retention) within three months following operation.ResultsA total of 665 patients who underwent elective transurethral procedures were enrolled. The transurethral procedures included monopolar transurethral resection of the prostate (M-TURP), bipolar TURP (B-TURP), greenlight photoselective vaporization of the prostate (PVP), thulium laser enucleation of the prostate (ThuLEP) and thulium laser transurethral vaporesection of the prostate (ThuVARP). Regarding ER visits for clot retention within three months, multivariable logistic regression revealed significantly lower rates of clot retention in patients who received B-TURP than in those who underwent ThuVARP (AOR, 0.18; 95% confidence interval [CI], 0.04–0.82, p = 0.027). Moreover, significantly higher clot retention was observed in patients who underwent two or more rounds of manual irrigation (AOR, 9.51; 95% CI, 1.66–54.43, p = 0.011).ConclusionMultiple manual irrigations shortly after operation can be considered a novel predictor of postoperative clot retention-related ER visits. Among the transurethral procedures, ThuVARP was associated with a higher risk of clot retention-related ER visits than was B-TURP.

V06-07 BLADDER INJURY DURING PROSTATIC ADENOMA MORCELLATION FOLLOWING THULIUM LASER ENUCLEATION OF THE PROSTATE

You have accessJournal of UrologyBPH & Infection & Imaging (V06)1 Sep 2021V06-07 BLADDER INJURY DURING PROSTATIC ADENOMA MORCELLATION FOLLOWING THULIUM LASER ENUCLEATION OF THE PROSTATE Serena Maruccia, Paolo Spiga, Maria Chiara Clementi, Giancarlo Galbiati, and Stefano Casellato Serena MarucciaSerena Maruccia More articles by this author , Paolo SpigaPaolo Spiga More articles by this author , Maria Chiara ClementiMaria Chiara Clementi More articles by this author , Giancarlo GalbiatiGiancarlo Galbiati More articles by this author , and Stefano CasellatoStefano Casellato More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002021.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Endoscopic enucleation of the prostate (EEP) is one of the most preferred minimally invasive surgical technique for benign prostatic hyperplasia (BPH) treatment. Capsular perforation, superficial bladder mucosal injury, ureteral orifice injury and morcellator malfunction are potential perioperative complications of EEP. Morcellation of prostatic adenoma is the most worrisom stage of the whole procedure and bladder injury may occur in 0.5% to 18.2% of cases. This Video shows the clinical management of bladder wall injury during morcellation. METHODS: The video, recorded in 2020, refers to a Thulium laser enucleation of the prostate (ThuLEP) performed in a patient suffering from lower urinary tract symptoms due to BPH. Enucleation is performed using a 26-French continuous flow scope, off-set laser bridge with a laser stabilization catheter, and a 800 µm Thulium laser fiber. Once the median and lateral lobes have been enucleated, the external sheath is removed and the nephroscope is inserted to facilitate morcellation. Under continuous inflow irrigation, the Cyber Blade TM morcellator (manufactured by Quanta System, Samarate, Italy) is introduced. A 3.5-MHz convex abdominal ultrasound transducer is used to visualize the bladder, predominantly in the sagittal orientation. Morcellation proceeds under simultaneous ultrasound and direct cystoscopic guidance. RESULTS: Despite ultrasound is an effective tool that makes the procedure safer, a bladder injury occurred. We managed the accident by stopping the suction and removing the morcellator blade from the lesion's site. A low power coagulation was performed on the bed and on the margins of lesion with Thulium laser. A postoperative ultrasound revealed no evidence of the pelvic and perivesical fluid. A catheter has been left on site for 36 hours.Patient was discharged on the second postoperative day being clinically asymptomatic. CONCLUSIONS: Extra attention should be paid during morcellation. In order to avoid bladder injuries, optimal hemostasis and bladder distention should be achieved before morcellation. Morcellation should be performed at a safe distance from the bladder mucosa. Superficial injuries may be treated with laser and should be managed conservatively with an indwelling catheter. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e450-e451 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Serena Maruccia More articles by this author Paolo Spiga More articles by this author Maria Chiara Clementi More articles by this author Giancarlo Galbiati More articles by this author Stefano Casellato More articles by this author Expand All Advertisement Loading ...

MP01-19 GOOGLE SEARCH TRENDS AND A BIBLIOMETRIC ANALYSIS OF ENDOSCOPIC SIZE INDEPENDENT BPH SURGERIES

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP01)1 Sep 2021MP01-19 GOOGLE SEARCH TRENDS AND A BIBLIOMETRIC ANALYSIS OF ENDOSCOPIC SIZE INDEPENDENT BPH SURGERIES Peace Orji, Henry Wright, Rebecca Campbell, William Jevnikar, Bradley Gill, and Smita De Peace OrjiPeace Orji More articles by this author , Henry WrightHenry Wright More articles by this author , Rebecca CampbellRebecca Campbell More articles by this author , William JevnikarWilliam Jevnikar More articles by this author , Bradley GillBradley Gill More articles by this author , and Smita DeSmita De More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001962.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) are common. Per the American Urologic Association guidelines, there are two prostate size-independent surgical options: holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP). This study evaluates public search interest in these procedures compared to the “gold standard,” transurethral resection of the prostate (TURP). Additionally, we present a correlation of public interest trends to bibliometric analysis of scientific publications. METHODS: Search behaviors for the terms “TURP”, “HoLEP”, and “ThuLEP” were analyzed from 2006-2019 using Google Trends data. Relative interest was evaluated between individual states, and internationally. Scopus was used for bibliometric analysis of HoLEP-related publications. RESULTS: Interest in TURP was greater than HoLEP and ThuLEP, though the magnitude of increase was less than HoLEP. Results for ThuLEP were insufficient for detailed analyses. In the US, TURP interest was greatest in South Dakota, West Virginia, Idaho, New Mexico, and Tennessee. HoLEP interest was greatest in Indiana, Arizona, Wisconsin, Michigan, and Ohio (Fig 1). Indiana and Arizona were the largest contributors of HoLEP-related publications; higher publication volume corresponded to higher search interest in the US (Fig 2). HoLEP search interest was greatest in New Zealand, United Kingdom, South Korea, Italy, and Turkey (Fig 3). Worldwide, higher publication frequency did not correspond to higher search interest. CONCLUSIONS: Though rising, HoLEP generates little public interest relative to TURP. States with the highest HoLEP-related publications also have the greatest public interest in HoLEP; however, this trend was not seen worldwide. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e8-e9 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peace Orji More articles by this author Henry Wright More articles by this author Rebecca Campbell More articles by this author William Jevnikar More articles by this author Bradley Gill More articles by this author Smita De More articles by this author Expand All Advertisement Loading ...

Educational value of YouTube Surgical Videos of Thulium Laser Enucleation of The Prostate (ThuLEP): the quality assessment.

BackgroundTo assess the educational value of YouTube surgical videos of thulium laser enucleation of the prostate (ThuLEP).MethodsA comprehensive search of “ThuLEP” or “thulium laser enucleation of the prostate” was performed on YouTube on October 31, 2020. According to the LAParoscopic surgery Video Educational GuidelineS, we created a checklist to assess the educational value of these videos. The checklist included 20 options. Each option represented one point. The total score was the sum of all the points. The higher score represents the higher educational value.ResultsA total of 70 videos were included. The average number of views were 1,366 (range, 11–30,884). The mean video length was 16.59 mins (range, 1.20–70.35 mins). Only 22.9% (16/70) videos had audio or/and written commentary in English language. Although 67.4% (47/70) videos were present step by step, only 21.4% (15/70) videos did the detailed explanation of critical steps. The mean score of the videos was 5.5 points (range, 1–15). No videos met all the points of the checklist. The mean percentage conformity of the videos was 28% (range, 5–75%). The educational score of the videos had no significant positive correlation with the number of views.ConclusionsThe majority of ThuLEP videos on YouTube platform have low educational value. Videos often lack important and detailed explanations about surgical procedures. The ThuLEP learner should watch these videos selectively. These findings remind us that a global effort should be made to improve the educational value of YouTube surgical videos, and more reporting guidelines about urological endoscopic surgery are still needed.

P0079 - Thulium Laser Enucleation (ThuLEP) versus Transurethral Bipolar Prostate Resection (TURP): Prospective randomized study: Early intra- and postoperative results

P0079 - Thulium Laser Enucleation (ThuLEP) versus Transurethral Bipolar Prostate Resection (TURP): Prospective randomized study: Early intra- and postoperative results

P0078 - Holmium laser versus thulium laser versus bipolar enucleation of the prostate for treatment of large sized benign prostatic enlargement. Preliminary report of a randomized controlled trial

P0078 - Holmium laser versus thulium laser versus bipolar enucleation of the prostate for treatment of large sized benign prostatic enlargement. Preliminary report of a randomized controlled trial

P0081 - Educational value of YouTube surgical videos of thulium laser enucleation of the prostate (ThuLEP): The quality assessment

Background To assess the educational value of YouTube surgical videos of laser enucleation of the (ThuLEP). Methods A comprehensive search of or thulium laser enucleation of the prostate was performed on YouTube on October 31, 2020. According to the LAParoscopic surgery Video Educational GuidelineS, we created a checklist to assess the educational value of these videos. The checklist included 20 options. Each option represented one point. The total score was the sum of all the points. The higher score represents the higher educational value. Results A total of 70 videos were included. The average number of views were 1,366 (range, 11-30,884). The mean video length was 16.59 mins (range, 1.20-70.35 mins). Only 22.9% (16/70) videos had audio or/and written commentary in English language. Although 67.4% (47/70) videos were present step by step, only 21.4% (15/70) videos did the detailed explanation of critical steps. The mean score of the videos was 5.5 points (range, 1-15). No videos met all the points of the checklist. The mean percentage conformity of the videos was 28% (range, 5-75%). The educational score of the videos had no significant positive correlation with the number of views. Conclusions The majority of ThuLEP videos on YouTube platform have low educational value. Videos often lack important and detailed explanations about surgical procedures. The ThuLEP learner should watch these videos selectively. These findings remind us that a global effort should be made to improve the educational value of YouTube surgical videos, and more reporting guidelines about urological endoscopic surgery are still needed.

P0585 - Laparoscopic partial nephrectomy with Thulium Laser enucleation of the tumour: Perioperative and functional outcomes

P0585 - Laparoscopic partial nephrectomy with Thulium Laser enucleation of the tumour: Perioperative and functional outcomes