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The efficacy and safety of 2-μm continuous laser in the treatment of high-risk patients with benign prostatic hyperplasia

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Abstract

Two-micrometer laser resection of prostate-tangerine technique dissects whole prostatic lobes off the surgical capsular, similar to peeling a tangerine. The present study aimed to evaluate the safety and efficacy of 2-μm continuous laser vaporization in the treatment of high-risk patients with benign prostatic hyperplasia (BPH) during the 24-month follow-up. The study included 248 patients with moderate to severe lower urinary tract symptoms who underwent 2-μm continuous laser vaporization of the prostate. All patients were accompanied with different degree comorbidities and 94 patients were taking oral anticoagulants. BPH was successfully treated with 2-μm continuous laser vaporization in all patients. Mean pre-operative prostate volume was 76 ± 25.3 ml and mean operative time was 49.8 ± 16.5 min. There were no major complications intra-operatively or postoperatively, and no blood transfusions were needed. About 20 patients (8.1%) needed bladder irrigation postoperatively. Average catheterization time was 2.0 ± 1.8 days (range 1–5 days). Four patients required reoperation due to enlarged prostates from residual adenoma. At 3-, 6-, 12-, and 24-month follow-ups, maximum urinary flow rates (Qmax) increased from 6.9 ± 1.7 to 19.1 ± 4.2, 19.5 ± 4.6, 19.4 ± 4.6, and 19.5 ± 4.1 ml/s, respectively. Mean International Prostate Symptom Scores (IPSS) decreased from 27.6 ± 5.1 (pre-operation) to 9.2 ± 2.6, 7.12 ± 1.42, 6.18 ± 1.32, and 6.25 ± 1.30 at 3-, 6-, 12-, and 24-month post-operation, respectively. Two-micrometer continuous laser vaporization is a safe and effective surgical endoscopic technique associated with low complication rate in BPH patients at high risk and those on anticoagulation therapy who have severe LUTS caused by BPH.

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References

  1. Berry SJ, Coffey DS, Walsh PC, Ewing LL (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479

    CAS  PubMed  Google Scholar 

  2. Souverein PC, Erkens JA, de la Rosette JJMCH, Leufkens HGM, Herings RMC (2003) Drug treatment of benign prostatic hyperplasia and hospital admission for BPH-related surgery. Eur Urol 43:528–534

    Article  CAS  PubMed  Google Scholar 

  3. Amen-Plama JA, Arteaga RB (2001) Hemostatic technique: extracapsular prostatic adenomectomy. J Urol 166:1364–1367

    Article  Google Scholar 

  4. Mebust WK (1998) Transurethral surgery. In: Walsh PC, Retik AB, Vaughan ED Jr (eds) Cambells, urology, 7th ed. vol II. WB Saunders, Philadelphia, pp 1511–1528

    Google Scholar 

  5. Reich O, Bachmann A, Siebels M, Hofstetter A, Stief CG, Sulser T (2005) High power (80 W) potassium-titanyl-phosphate laser vaporization of the prostate in 66 high risk patients. J Urol 173:158–160

    Article  PubMed  Google Scholar 

  6. AUA Practice Guidelines Committee (2003) AUA guideline on management of benign prostatic hyperplasia: diagnosis and treatment recommendations. J Urol 170:530–547

    Article  Google Scholar 

  7. Cleynenbreuel BV, Srirangam SJ, Van Poppel H (2009) High performance system Greenlight laser: indications and outcomes. Curr Opin Urol 19:33–37

    Article  Google Scholar 

  8. Costello AJ, Bowsher WG, Bolton DM, Braslis KG, Burt J (1992) Laser ablation of the prostate in patients with benign prostatic hypertrophy. BJU Int 69:603–608

    Article  CAS  Google Scholar 

  9. Muschter R, Hofstetter A (1995) Interstitial laser therapy outcomes in benign prostatic hyperplasia. J Endourol 9:129–135

    Article  CAS  PubMed  Google Scholar 

  10. Ahyai SA, Gilling P, Kaplan SA et al (2010) Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol 58:384–397

    Article  PubMed  Google Scholar 

  11. Gilling PJ, Wilson LC, King CJ et al (2012) Long-term results of a randomized trial comparing holium laser enucleation of the prostate and transurethral resection of the prostate: result at 7 years. BJU Int 109:408–411

    Article  PubMed  Google Scholar 

  12. Malde S, Rajagopalan A, Patel N et al (2012) Potassium-titanyl-phosphate laser photoselective vaporization for benign prostatic hyperplasia: 5-year follow-up from a district general hospital. J Endoural 26:278–283

    Article  Google Scholar 

  13. Fried NM, Murry KE (2005) High-power thulium fiber laser ablation of urinary tissues at 1.94 micrometers. J Endourol 19:25–31

    Article  PubMed  Google Scholar 

  14. Bach T, Herrmann TR, Ganzer R et al (2007) Revolix vaporesection of the prostate: initial results of 54 patients with a 1-year follow-up. World J Urol 25:257–262

    Article  PubMed  Google Scholar 

  15. Wei HB, Zhuo J, Sun XW et al (2014) Safety and efficiency of thulium laser prostate resection for the treatment of benign prostatic hyperplasia in large prostates. Laser Med Sci 29:957–963

    Article  Google Scholar 

  16. Cui D, Sun F, Zhuo J et al (2014) A randomized comparing thulium laser resection to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: four-year follow-up results. World J Urol 32:683–689

    Article  PubMed  Google Scholar 

  17. Zhuo J, Wei HB, Zhao FJ et al (2014) Two-micrometer thulium laser resection of the prostate-tangerine technique for patients with acute urinary retention. Laser Med Sci 29:1093–1098

    Article  Google Scholar 

  18. Saklad M (1941) Grading of patients for surgical procedures. Anesthesiology 2:281–284

    Article  Google Scholar 

  19. Bach T, Huck N, Wezel F et al (2010) 70 vs 120W thulium:yttrium-aluminium-garnet 2 micron continuous-wave laser for the treatment of benign prostatic hyperplasia: a systematic ex-vivo evaluation. BJU Int 106(3):368–372

    Article  PubMed  Google Scholar 

  20. Xia S, Zhuo J, Sun X et al (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 53:382–390

    Article  PubMed  Google Scholar 

  21. Xia SJ (2009) Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment. Asia J Androl 11:277–281

    Article  CAS  Google Scholar 

  22. Lepor H (2004) Pathophysiology, epidemiology, and natural history of benign prostatic hyperplasia. Rev Urol 6(suppl):3–10

    Google Scholar 

  23. McVary KT, Roehrborn CG, Avins AL et al (2011) Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 185:1793–1803

    Article  PubMed  Google Scholar 

  24. Gunnar WN, Stephanie H, Patrick H et al (2008) Systematic evaluation of a recently introduced 2-um continuous-wave thulium laser for vaporesection of the prostate. J Endourol 22(5):1041–1046

    Article  Google Scholar 

  25. Netsch C, Pohlmann L, Herrmann TR et al (2012) 120-W 2um thulium:yttrium-garnet vapoenucleation of the prostate: 12-month follow-up. BIU Int 110(1):96–101

    Google Scholar 

  26. Hauser S, Rogenhofer S, Ellinger J et al (2012) Thulium laser (revolix) vapoenucleation of the prostate is a safe procedure in patients with an increased risk of hemorrhage. Urol Int 88(4):390–394

    Article  PubMed  Google Scholar 

  27. Rieken M, Ebinger Mundorff N, Bonkat G et al (2010) Complications of laser prostatectomy: a review of recent data. World J Urol 28(1):53–62

    Article  PubMed  Google Scholar 

  28. Si JM, Gu BJ, Yu JJ et al (2011) The Revolix 2 micron continuous wave laser vaporesection for the treatment of high-risk patients with benign prostatic hyperplasia. Photomed Laser Sur 29(2):105–107

    Article  CAS  Google Scholar 

  29. Zhu ZW, Shen ZJ, Tu FZ et al (2012) Thulium laser vaporesection verus transurethral electrovaporization of the prostate in high-risk patients with benign prostatic hyperplasia. Photomed Laser Sur 30(12):714–718

    Article  Google Scholar 

  30. Wei HB, Zhuo J, Sun XW et al (2014) Safety and efficiency of thulium laser prostate resection for the treatment of benign prostatic hyperplasia in large prostate. Lasers Med Sci 29:957–963

    Article  PubMed  Google Scholar 

  31. Zhu YP, Zhuo J, Xu DL et al (2015) Thulium laser versus standard transurethral resection of the prostate for benign prostatic obstruction: a systematic review and meta-analysis. World J Urol 33(4):509–515

    Article  CAS  PubMed  Google Scholar 

  32. Cui D, Sun F, Zhuo J, et al. A randomized trial comparing thulium laser resection to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: four-year follow-up results. World J Urol. 2014;32(3):683-9

  33. Zhang F, Shao Q, Herrmann TR et al (2012) Thulium laser versus holmium lase transurethral enucleation of the prostate: 18-month follow-up data of a single center. Urology 79(4):869–874

    Article  PubMed  Google Scholar 

  34. Liu CL, Xue DW, Liu YL et al (2011) Greenlight photoselective vaporization prostatectomy versus thulium laser vaporesection of the prostate for aged high-risk BPH patients with the prostate heavier than 80g. Zhonghua Nan Ke Xue 17(5):431–434

    PubMed  Google Scholar 

  35. Tao W, Xue BX, Zang YC et al (2013) The application of 120-W high-performance system GreenLight laser vaporization of the prostate in high-risk patients. Lasers Med Sci 28(4):1151–1157

    Article  PubMed  Google Scholar 

  36. Dotan ZA, Mor Y, Leibovitch I et al (2003) The efficacy and safety of perioperative low molecular weight heparin substitution in patients on chronic oral anticoagulant therapy undergoing transurethral prostatectomy for bladder outlet obstruction. J Urol 168:610–614

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, China

    Wei Tao, Chuanyang Sun, Boxin Xue, Dongrong Yang, Chunjie Cai & Yuxi Shan

  2. Department of Urology, The Sir Run Run Shaw Hospital, College of Medical Sciences, Zhejiang University, Hangzhou, China

    Mingchao Wang

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  1. Wei Tao
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  2. Chuanyang Sun
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  3. Boxin Xue
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Correspondence to Wei Tao.

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Tao, W., Sun, C., Xue, B. et al. The efficacy and safety of 2-μm continuous laser in the treatment of high-risk patients with benign prostatic hyperplasia. Lasers Med Sci 32, 351–356 (2017). https://doi.org/10.1007/s10103-016-2122-5

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  • DOI: https://doi.org/10.1007/s10103-016-2122-5

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