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Thulium vapoenucleation of the prostate versus holmium laser enucleation of the prostate for the treatment of large volume prostates: preliminary 6-month safety and efficacy results of a prospective randomized trial

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Abstract

Purpose

We compared the perioperative and postoperative characteristics of thulium vapoenucleation and holmium laser enucleation of the prostate for the treatment of large volume benign prostatic hyperplasia.

Materials and methods

A total of 94 patients with benign prostatic hyperplasia and a median prostate size of 80 (IQR 46.75–100) cc were either randomized to thulium vapoenucleation or holmium laser enucleation of the prostate. Patients were assessed preoperatively, 1 and 6 months postoperatively.

Results

The median operative time was 60 (IQR 41–79) min without significant differences between the groups. There were no significant differences between the groups regarding catheter time [2 (IQR 2–2) days] and postoperative stay [2 (IQR 2–3) days]. Clavien 1 (13.8%), 2 (3.2%), 3a (2.1%), and Clavien 3b (4.3%) complications occurred without significant differences between the groups. At 6-month follow-up, median maximum flow rate (10.7 vs. 25.9 ml/s), post-void residual urine (100 vs. 6.5 ml), I-PSS (20 vs. 5), quality of life (4 vs. 1), PSA (4.14 vs. 0.71 µg/l), and prostate volume (80 vs. 16 ml) had improved significantly (p < 0.001) compared to baseline without significant differences between the groups. Median PSA decrease was 79.7% (58.8–90.6%) and prostate volume reduction was 74.5% (68.57–87.63%) without differences between the groups. The reoperation rate was zero at 6-month follow-up.

Conclusions

Thulium vapoenucleation and holmium laser enucleation of the prostate are safe and effective procedures for the treatment of large volume benign prostatic hyperplasia. Both procedures give satisfactory micturition improvement with low morbidity and sufficient prostate volume reduction at 6-month follow-up.

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Funding

Funding was obtained from Boston Scientific (grant number:#ISRURO400001)

Author information

Authors and Affiliations

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

    B. Becker, A. J. Gross & C. Netsch

  2. Department of Urology, MHH Medical School of Hanover, Carl-Neubergstr. 1, 30625, Hannover, Germany

    T. R. W. Herrmann

Authors
  1. B. Becker
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  2. T. R. W. Herrmann
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  3. A. J. Gross
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  4. C. Netsch
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Contributions

All authors whose names appear on the submission have contributed sufficiently to the scientific work and, therefore, share collective responsibility and accountability for the results. B: Protocol/project development, data collection, data analysis, manuscript writing/editing, H: Protocol/project development, manuscript writing/editing, G: Protocol/project development, data collection, manuscript writing/editing, N: Protocol/project development, Data collection, data analysis, manuscript writing/editing

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Correspondence to B. Becker.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Becker, B., Herrmann, T.R.W., Gross, A.J. et al. Thulium vapoenucleation of the prostate versus holmium laser enucleation of the prostate for the treatment of large volume prostates: preliminary 6-month safety and efficacy results of a prospective randomized trial. World J Urol 36, 1663–1671 (2018). https://doi.org/10.1007/s00345-018-2321-8

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  • DOI: https://doi.org/10.1007/s00345-018-2321-8

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