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Safety and effectiveness of Thulium VapoEnucleation of the prostate (ThuVEP) in patients on anticoagulant therapy

World Journal of Urology volume 32, pages 165–172 (2014)Cite this article

Abstract

Introduction

To evaluate the safety and efficacy of Thulium VapoEnucleation of the prostate (ThuVEP) for patients on oral anticoagulants (OA) with symptomatic benign prostatic obstruction (BPO).

Methods

Fifty-six patients, undergoing ThuVEP at two institutions, were evaluated from May 2009 until June 2011. All patients were at high cardiopulmonary risk and presented with a median American Society of Anesthesiology score of 3 [interquartile range (IQR) 2–3]. Thirty-two patients were on aspirin, 8 were on clopidogrel or clopidogrel and aspirin, and 16 on phenprocoumon at the time of surgery. Patient demographic, perioperative, and follow-up data were analyzed.

Results

Median prostate volume was 50 (IQR 34–76) cc, and resected tissue weight was 32 (IQR 20–50) g. The median operative time was 61.5 (IQR 40–100.75) min, and the catheter time 2 (IQR 2–3) days. There were no perioperative thromboembolic events. Five patients (8.9 %) required a second-look operation in the immediate postoperative course (hemorrhage n = 4, residual adenoma n = 1) and four (7.1 %) blood transfusions. Complications within the first 30 days included urinary tract infections (1.7 %), urinary retention (3.6 %), and delayed bleeding (7.1 %). These complications were managed conservatively. At 12-month follow-up, median QoL [5 (IQR 3.75–5) vs. 1 (IQR 1–2)], IPSS [21.5 (IQR 15.5–23.75) vs. 5 (IQR 3–8)], Qmax [7.7 (IQR 6.3–10) vs. 28.3 (IQR 21.25–39.2) ml/s], and postvoiding residual urine [100 (IQR 46–200) vs. 17.5 (IQR 0–36) ml] improved significantly (p < 0.002).

Conclusions

Thulium VapoEnucleation of the prostate seems to be a safe and efficacious procedure for the treatment of symptomatic BPO in patients at high cardiopulmonary risk on OA.

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Conflict of interest

The authors have nothing to disclose.

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Affiliations

  1. Department of Urology, Asklepios Hospital Barmbek, Rübenkamp 220, 22291, Hamburg, Germany

    Christopher Netsch, T. Bach & A. J. Gross

  2. Department of Urology, MHH Medical School of Hannover, Hannover, Germany

    M. Stoehrer, M. Brüning, A. Gabuev & T. R. W. Herrmann

  3. Department of Urology, Asklepios Hospital Harburg, Hamburg, Germany

    T. Bach

Authors
  1. Christopher Netsch
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  2. M. Stoehrer
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  3. M. Brüning
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  4. A. Gabuev
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  5. T. Bach
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  6. T. R. W. Herrmann
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  7. A. J. Gross
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Correspondence to Christopher Netsch.

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Netsch, C., Stoehrer, M., Brüning, M. et al. Safety and effectiveness of Thulium VapoEnucleation of the prostate (ThuVEP) in patients on anticoagulant therapy. World J Urol 32, 165–172 (2014). https://doi.org/10.1007/s00345-013-1093-4

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  • DOI: https://doi.org/10.1007/s00345-013-1093-4

Keywords

  • Benign prostatic obstruction (BPO)
  • VapoEnucleation
  • Tm:YAG
  • Revolix
  • ThuVEP
  • Anticoagulants