Skip to main content

Advertisement

SpringerLink
Log in

Long-term results of thulium laser resection of the prostate: a prospective study at multiple centers

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the long-term durability and complication rates after thulium laser resection of prostate (TmLRP) through a prospective multiple-center study.

Materials and methods

From November 2004 to December 2011, we prospectively studied 2,216 patients with symptomatic benign prostatic hyperplasia (BPH) treated with thulium laser resection of the prostate at four medical centers. Patients were assessed on International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR). Perioperative complications were classified according to the modified Clavien classification system.

Results

Of 2,216 patients treated with TmLRP, 1,353 (61.1 %), 1,129 (50.9 %), 847 (38.2 %), and 541 (24.4 %) patients were followed at 5, 6, 7, and 8 years, respectively. Postoperatively, IPSS, QoL, Qmax, and PVR showed a significant improvement from 3 month after surgery and remained significantly improved during the entire follow-up period (p < 0.01). Minor complications occurred in 526 (23.7 %) of the 2,216 patients (Clavien 1: 21.5 %; Clavien 2: 2.3 %). Major complications requiring re-interventions occurred in 48 (2.2 %) of the 2,216 patients (Clavien 3: 2.2 %). No Clavien 4 or Clavien 5 complication had occurred. Urethral stricture and bladder neck contracture occurred in 2.6 % (58) and 1.6 % (35) patients, respectively. Persistent stress incontinence was found in 0.1 % (2) of the patients. Re-operation as a result of BPH recurrence was required in 1.2 % (27) patients.

Conclusions

Thulium laser resection of the prostate is a safe and effective procedure with excellent durability in the treatment of symptomatic BPH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, N’Dow J, Nordling J, de la Rosette JJ (2013) EAU Guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. doi:10.1016/j.eururo.2013.03.004

    Google Scholar 

  2. Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, Lack N, Stief CG (2008) morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180(1):246–249. doi:10.1016/j.juro.2008.03.058

    Article  PubMed  Google Scholar 

  3. Rassweiler J, Teber D, Kuntz R, Hofmann R (2006) Complications of transurethral resection of the prostate (TURP)–incidence, management, and prevention. Eur Urol 50(5):969–979. doi:10.1016/j.eururo.2005.12.042 (discussion 980)

  4. Reich O, Gratzke C, Stief CG (2006) Techniques and long-term results of surgical procedures for BPH. Eur Urol 49(6):970–978. doi:10.1016/j.eururo.2005.12.072

    Article  PubMed  Google Scholar 

  5. Gravas S, Bachmann A, Reich O, Roehrborn CG, Gilling PJ, De La Rosette J (2011) Critical review of lasers in benign prostatic hyperplasia (BPH). BJU Int 107(7):1030–1043. doi:10.1111/j.1464-410X.2010.09954.x

    Article  PubMed  Google Scholar 

  6. Bachmann A, Woo HH, Wyler S (2012) Laser prostatectomy of lower urinary tract symptoms due to benign prostate enlargement. Curr Opin Urol 22(1):22–33. doi:10.1097/MOU.0b013e32834dd0ed

    Article  PubMed  Google Scholar 

  7. Hoekstra RJ, Van Melick HHE, Kok ET, Ruud Bosch JLH (2010) A 10-year follow-up after transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia; long-term results of a randomized controlled trial. BJU Int 106(6):822–826. doi:10.1111/j.1464-410X.2010.09229.x

    Article  PubMed  Google Scholar 

  8. Xia SJ, Zhang YN, Lu J, Sun XW, Zhang J, Zhu YY, Li WG (2005) Thulium laser resection of prostate-tangerine technique in treatment of benign prostate hyperplasia. Zhonghua Yi Xue Za Zhi 85(45):3225–3228

    PubMed  Google Scholar 

  9. Xia S-J, Zhuo J, Sun X-W, Han B-M, Shao Y, Zhang Y-N (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 53(2):382–390. doi:10.1016/j.eururo.2007.05.019

    Article  PubMed  Google Scholar 

  10. Fu WJ, Zhang X, Yang Y, Hong BF, Gao JP, Cai W, Zhang P, Wang XX (2010) Comparison of 2-μm continuous wave laser vaporesection of the prostate and transurethral resection of the prostate: a prospective nonrandomized trial with 1-year follow-up. Urology 75(1):194–199. doi:10.1016/j.urology.2009.07.1266

    Article  PubMed  Google Scholar 

  11. Peng B, Wang G-c, Zheng J-h, Xia S-q, Geng J, Che J-p, Yan Y, Huang J-h, Xu Y-F, Yang B (2012) A comparative study of thulium laser resection of the prostate and bipolar transurethral plasmakinetic prostatectomy for treating benign prostatic hyperplasia. BJU Int. doi:10.1111/j.1464-410X.2012.11610.x

    PubMed Central  Google Scholar 

  12. Shu-Jie X (2009) Two-micron (thulium) laser resection of the prostate-tangerine technique: a new method for BPH treatment. Asian J Androl 11(3):277–281. doi:10.1038/aja.2009.17

    Article  Google Scholar 

  13. Cui D, Sun F, Zhuo J, Sun X, Han B, Zhao F, Jing Y, Lu J, Xia S (2013) 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. doi:10.1007/s00345-013-1103-6

    PubMed  Google Scholar 

  14. Tascı AI, Ilbey YO, Tugcu V, Cicekler O, Cevik C, Zoroglu F (2011) Transurethral resection of the prostate with monopolar resectoscope: single-surgeon experience and long-term results of after 3589 procedures. Urology 78(5):1151–1155. doi:10.1016/j.urology.2011.04.072

    Article  PubMed  Google Scholar 

  15. Neyer M, Reissigl A, Schwab C, Pointner J, Abt D, Bachmayer C, Schmid H-P, Engeler DS (2013) Bipolar versus monopolar transurethral resection of the prostate: results of a comparative, prospective bicenter study—perioperative outcome and long-term efficacy. Urol Int 90(1):62–67. doi:10.1159/000343688

    Article  PubMed  Google Scholar 

  16. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications. Ann Surg 240(2):205–213. doi:10.1097/01.sla.0000133083.54934.ae

    Article  PubMed Central  PubMed  Google Scholar 

  17. Mamoulakis C, Efthimiou I, Kazoulis S, Christoulakis I, Sofras F (2010) The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate. World J Urol 29(2):205–210. doi:10.1007/s00345-010-0566-y

    Article  PubMed Central  PubMed  Google Scholar 

  18. Gross AJ, Netsch C, Knipper S, Hölzel J, Bach T (2012) Complications and early postoperative outcome in 1080 patients after thulium vapoenucleation of the prostate: results at a single institution. Eur Urol. doi:10.1016/j.eururo.2012.11.048

    Google Scholar 

  19. Wei H, Shao Y, Sun F, Sun X, Zhuo J, Zhao F, Han B, Jiang J, Chen H, Xia S (2013) Thulium laser resection versus plasmakinetic resection of prostates larger than 80 ml. World J Urol. doi:10.1007/s00345-013-1210-4

    PubMed  Google Scholar 

  20. Tang K, Xu Z, Xia D, Ma X, Guo X, Guan W, Hu Z, Zhang X, Ye Z, Xu H (2013) Early Outcomes of Thulium Laser Versus Transurethral Resection of the Prostate for Managing Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis of Comparative Studies. J Endourol. 131104051502003. doi:10.1089/end.2013.0404

  21. Fried NM (2005) High-power laser vaporization of the canine prostate using a 110 W Thulium fiber laser at 1.91 ?m. Lasers Surg Med 36(1):52–56. doi:10.1002/lsm.20126

    Article  PubMed  Google Scholar 

  22. Wendt-Nordahl G, Huckele S, Honeck P, Alken P, Knoll T, Michel MS, Häcker A (2008) Systematic evaluation of a recently introduced 2-μm continuous-wave thulium laser for vaporesection of the prostate. J Endourol 22(5):1041–1046. doi:10.1089/end.2007.0421

    Article  PubMed  Google Scholar 

  23. Szlauer R, Götschl R, Razmaria A, Paras L, Schmeller NT (2009) Endoscopic vaporesection of the prostate using the continuous-wave 2-μm thulium laser: outcome and demonstration of the surgical technique. Eur Urol 55(2):368–375. doi:10.1016/j.eururo.2008.10.034

    Article  PubMed  Google Scholar 

  24. Rassweiler J, Teber D, Kuntz R, Hofmann R (2006) Complications of transurethral resection of the prostate (turp)—incidence, management, and prevention. Eur Urol 50(5):969–980. doi:10.1016/j.eururo.2005.12.042

    Article  PubMed  Google Scholar 

  25. Elmansy HM, Kotb A, Elhilali MM (2011) Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of followup. J Urol 186(5):1972–1976. doi:10.1016/j.juro.2011.06.065

    Article  PubMed  Google Scholar 

  26. Zhuo J, Xia S-J (2013) Is it necessary and feasible to increase the efficiency of 2-µm thulium laser resection of the prostate? Asian J Androl 15(4):453–454. doi:10.1038/aja.2013.28

    Article  PubMed Central  PubMed  Google Scholar 

  27. Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR (2012) Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 109(3):408–411. doi:10.1111/j.1464-410X.2011.10359.x

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have nothing to disclose.

Ethical standard

We state that our manuscript has not and will not be submitted for publication elsewhere.

Author information

Authors and Affiliations

  1. Department of Urology, Shanghai First People’s Hospital, School of Medicine, Shanghai Jiao Tong University, No.100, Haining Road, Shanghai, 200080, China

    Feng Sun, Bangmin Han, Di Cui, Fujun Zhao, Xiaowen Sun, Jian Zhuo, Yifeng Jing, Haitao Liu & Shujie Xia

  2. Department of Urology, Chinese People’s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Beijing, 100853, China

    Yong Yang

  3. Department of Urology, Guizhou Provincial People’s Hospital, No.83, East Zhongshan Road, Guiyang, 550002, China

    Guangheng Luo

  4. Department of Urology, Linyi People’s Hospital, Linyi, 276000, China

    Fengfu Guo

Authors
  1. Feng Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bangmin Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Di Cui
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fujun Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiaowen Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jian Zhuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yifeng Jing
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Haitao Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shujie Xia
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yong Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Guangheng Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Fengfu Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Shujie Xia, Yong Yang, Guangheng Luo or Fengfu Guo.

Additional information

Feng Sun and Bangmin Han contributed equally to this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sun, F., Han, B., Cui, D. et al. Long-term results of thulium laser resection of the prostate: a prospective study at multiple centers. World J Urol 33, 503–508 (2015). https://doi.org/10.1007/s00345-014-1456-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-014-1456-5

Keywords

Search

Navigation