Long-term results of multimodal treatment of the prostate using the Thulium Laser.

Autor: Coman RA; Department of Urology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.; Endoplus Clinic, Cluj-Napoca, Romania., Leucuta DC; Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania., Coman RT; Department of Epidemiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania., Lapusan C; Endoplus Clinic, Cluj-Napoca, Romania., Stanca DV; Department of Urology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania., Coman I; Department of Urology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.; Endoplus Clinic, Cluj-Napoca, Romania., Al Hajjar N; Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.; Department of Surgery, 'Octavian Fodor' Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
Jazyk: angličtina
Zdroj: Medicine and pharmacy reports [Med Pharm Rep] 2024 Jul; Vol. 97 (3), pp. 338-346. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.15386/mpr-2760
Abstrakt: Background and Aims: To evaluate a novel multimodal treatment (TLP) that integrates the use of a thulium laser, bipolar transurethral resection of the prostate (TURP), and "button-type" bipolar plasma vaporization for the endoscopic treatment of benign prostatic hyperplasia (BPH).
Methods: From March 2018 to December 2021, we prospectively evaluated 220 patients with symptomatic BPH who underwent TLP. Patients were assessed based on the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR). Perioperative and postoperative follow-up data were analyzed.
Results: The mean age at surgery was 66.74 years (SD 8.21). The median prostate size was 80 (IQR 70 - 110). The median operative time was 45 (IQR 35 - 55) minutes and the hospital stay was 2 (IQR 1 - 2) days. Patients were discharged with the urinary catheter in place, which was removed approximately 7 days after surgery when the histopathological result was discussed with the patient. Postoperatively, IPSS, QoL, Qmax and PVR showed a significant improvement starting at 3 months and continued through the postoperative follow-up visits (6-12-24-36-48-60 months). Urethral stricture and bladder neck contracture occurred in 1 (0.45%) and 2 (0.91%) patients, respectively. Recurrence of BPH occurred in 2 patients (0.91%) who underwent a second procedure.
Conclusions: In conclusion, we report that the multimodal surgical treatment of BPH consisting of combining Thulium laser vaporization, bipolar TURP and plasma vaporization (TLP) represents an efficient and durable therapeutic method for BPH patients with low a complication rate at 5-year follow-up.
Databáze: MEDLINE
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