Five-year outcomes of thulium vapoenucleation of the prostate for symptomatic benign prostatic obstruction
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Introduction and objectives
To assess the 5-year outcomes of thulium vapoenucleation of the prostate (ThuVEP) in patients with benign prostatic obstruction (BPO) retrospectively.
Five-hundred patients were treated with ThuVEP between January 2007 and January 2010 at our institution. Patients were reassessed 1 and 5-years after ThuVEP with International Prostate Symptom Score (IPSS), Quality of Life (QoL), urinary peak flow (Qmax), postvoid residual volume (PVR), PSA and prostate volume. Patient data were expressed as median (interquartile range).
One-hundred and thirty-one patients completed the 5-year follow-up. According to preoperative prostate volume, patients were divided into two groups: group A (<60 ml, n = 80) and B (≥60 ml, n = 51). IPSS, QoL, Qmax, and PVR improved significantly at discharge and continued to do so during 5-year follow-up (p ≤ 0.001). At 1-year follow-up, prostate volume had decreased significantly (50 vs. 13 mL, p < 0.001) corresponding to a prostate volume reduction of 80.8%. PSA was significantly reduced at 5-year (0.72 µg/l) follow-up compared to preoperative PSA (3.39 µg/l, p ≤ 0.001). PSA-reduction (total 77.1%) at 5-year follow-up was significantly different between group A (70.2%) and B (83.5%) (p ≤ 0.006). IPSS was significantly lower in group B than in A (2.5 vs. 6, p < 0.001) at 5-year follow-up. Bladder neck contractures (n = 4) and urethral strictures (n = 4) occurred in 3.1% of the patients each. Three patients (2.3%) were re-treated for regrowth of prostatic tissue.
ThuVEP is a durable procedure with regard to micturition improvement and PSA-reduction. The reintervention rate after ThuVEP was low during long-term follow-up.
KeywordsBPO Benign prostatic obstruction Vapoenucleation ThuVEP PSA Laser surgery, Tm:YAG Long-term Lasers
Author contribution statement
A. J. Gross: Project development, Manuscript writing, Data analysis and interpretation. A. K. Orywal: Data collection, Manuscript writing. B. Becker: Data collection, Manuscript editing. C. Netsch: Project development, Manuscript editing, Data analysis and interpretation.
Compliance with ethical standards
Conflict of interest
The authors have nothing to disclose.
All patients were treated after obtaining informed consent, following institutional review board approval.
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