Email this article Thulium laser enucleation of prostate (ThuLEP): efficacy and safety evaluation in patients with a prostate volume more than 80 cm3
- Authors: Kostenkov N.Y.1,2, Al-Shukri S.K.1, Amdiy R.E.1, Nevirovich E.S.1,2, Tkachuk I.N.3,4, Novitsky A.V.2
-
Affiliations:
- Academician I.P. Pavlov First St. Petersburg State Medical University
- City Hospital No. 15
- Academician I.P. Pavlov First St Petersburg State Medical University
- City Hospital №15
- Issue: Vol 12, No 3 (2022)
- Pages: 211-220
- Section: Original articles
- URL: https://journal-vniispk.ru/uroved/article/view/110730
- DOI: https://doi.org/10.17816/uroved110730
- ID: 110730
Cite item
Open Access
Access granted
Subscription Access
Abstract
BACKGROUND: Benign prostatic hyperplasia is a common condition in men over 60 years of age. The gold standard for the treatment of benign prostatic hyperplasia up to 80 cm3 is transurethral resection of the prostate. At the same time, with a prostate volume of more than 80 cm3, the choice of the optimal method of surgical treatment of benign prostatic hyperplasia is a matter of debate.
AIM: Evaluation of the efficacy and safety of thulium laser enucleation of the prostate (ThuLEP) in patients with benign prostatic hyperplasia with a prostate volume of more than 80 cm3.
MATERIALS AND METHODS: The study involved 75 patients with benign prostatic hyperplasia aged 64 to 83 years (mean age 70.4 years) with a prostate volume of 80 to 215 cm3 (mean 123.9 cm3). All patients underwent ThuLEP using a thulium fiber laser FiberLase U1 with a power of 120 W. Control examinations were performed 3 and 6 months after the surgery.
RESULTS: The duration of surgery averaged 84.7 minutes and ranged from 57 to 135 minutes. The duration of the urethral catheter after surgery averaged 2.8 days. The frequency of intra- and postoperative complications was low, none of the patients required blood transfusion, as well as repeated surgery to coagulate the vessels of the prostate bed. In 3 (4%) patients, superficial damage to the bladder wall occurred during marcellation, which required coagulation of the injury site. All recorded complications belonged to groups I and II according to the Clavien – Dindo scale. Examinations carried out after 3 and 6 months showed a significant decrease in the severity of voiding disorders, an increase in the quality of life and an improvement in the outflow of urine from the bladder compared with the baseline.
CONCLUSIONS: The results of the study showed high clinical efficacy and safety of the use of thulium laser enucleation of benign prostatic hyperplasia in patients with prostates more than 80 cm3.
Full Text
##article.viewOnOriginalSite##About the authors
Nikolay Yu. Kostenkov
Academician I.P. Pavlov First St. Petersburg State Medical University; City Hospital No. 15
Email: drkostenkov@rambler.ru
ORCID iD: 0000-0001-8246-8798
SPIN-code: 2041-8837
Postgraduate Student, Urologist
Russian Federation, 6–8, L’va Tolstogo st., Saint Petersburg, 197022; Saint PetersburgSalman Kh. Al-Shukri
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: alshukri@mail.ru
ORCID iD: 0000-0002-4857-0542
Scopus Author ID: 6506423220
Dr. Sci. (Med.), Professor, Head of the Department of Urology
Russian Federation, 6–8, Lva Tolstogo str., Saint Petersburg, 197022Refat E. Amdiy
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: r.e.amdiy@mail.ru
ORCID iD: 0000-0003-1305-5791
SPIN-code: 2399-7041
Scopus Author ID: 6506347944
MD, Dr. Sci. (Med.), Professor of the Department of Urology
Russian Federation, 6-8, Lva Tolstogo st., Saint-Petersburg, 197022Evgeniy S. Nevirovich
Academician I.P. Pavlov First St. Petersburg State Medical University; City Hospital No. 15
Email: enevirovich@gmail.com
ORCID iD: 0000-0001-8427-5092
SPIN-code: 9362-4145
MD, Cand. Sci. (Med.), Associate Professor of the Department of Urology; Head of the urological unit
Russian Federation, 6-8, Lva Tolstogo st., Saint-Petersburg, 197022; St. PetersburgIlia N. Tkachuk
Academician I.P. Pavlov First St Petersburg State Medical University; City Hospital №15
Email: tkachuk2@yandex.ru
MD, Cand. Sci. (Med.), Associate Professor of the Department of Urology, Urologist
Russian Federation, 6-8, Lva Tolstogo st., Saint-Petersburg, 197022; Saint PetersburgAndrey V. Novitsky
City Hospital No. 15
Author for correspondence.
Email: b15@zdrav.spb.ru
MD, Dr. Sci. (Med.), Chief Physician
Russian Federation, 6–8, L’va Tolstogo st., Saint Petersburg, 197022References
- Korneyev IA, Alexeeva TA, Al-Shukri SH, Pushkar DYu. Lower urinary tract symptoms in male population of the Russian Federation North-Western Region: analysis of population study results. Urologicheskie Vedomosti. 2016;6(1):5–9. (In Russ.) doi: 10.17816/uroved615-9
- Amdii RE. Diagnosticheskoe i prognosticheskoe znachenie urodinamicheskikh issledovanii nizhnikh mochevykh putei u bol’nykh s infravezikal’noi obstruktsiei i narusheniem sokratimosti detruzora [dissertation abstract]. Saint Petersburg; 2007. Available from: https://www.dissercat.com/content/diagnosticheskoe-i-prognosticheskoe-znachenie-urodinamicheskikh-issledovanii-nizhnikh-mochev/read (In Russ.)
- Pushkar’ DYu, Bernikov AN, Khodyreva LA, et al. Quality of life in patients with lower urinary tract symptoms after TURP for benign prostatic hyperplasia. Urologiia. 2018;(1):53–61. (In Russ.) doi: 10.18565/urology.2018.1.53-61
- Zhang MW, El Tayeb MM, Borofsky MS, et al. Comparison of perioperative outcomes between holmium laser enucleation of the prostate and robot-assisted simple prostatectomy. J Endourol. 2017;31(9):847–850. doi: 10.1089/end.2017.0095
- Dobrokachestvennaya giperplaziya predstatel’noi zhelezy. Klinicheskie rekomendatsii Minzdrava RF. 2020. Available from: https://cr.minzdrav.gov.ru/recomend/6_. (In Russ.)
- Kuz’min IV, Novitskii AV, Nevirovich ES, et al. Peculiarities of treatment of gerontological patients with benign prostate hyperplasia of large sizes in combination with stric asthenia syndrome. Scientific Journal Current Problems of Health Care and Medical Statistics. 2021;(2):97–107. doi: 10.24412/2312-2935-2021-2-97-107
- Lokeshwar SD, Harper BT, Webb E, et al. Epidemiology and treatment modalities for the management of benign prostatic hyperplasia. Transl Androl Urol. 2019;8(5):529–539. doi: 10.21037/tau.2019.10.01
- Martov AG, Ergakov DV, Turin DE, Andronov AS. Bipolar and laser endoscopic enucleation for large benign prostatic hyperplasia. Urologiia. 2020;(1):59–63. (In Russ.) doi: 10.18565/urology.2020.1.59-63
- Vydrin PS, Kalinina SN, Burlaka OO, Aleksandrov MS. Assessment of copulative function and severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia after transurethral enucleation. Urology reports (St. Petersburg). 2021;11(2):123–132. (In Russ.) doi: 10.17816/uroved55409
- Enikeev DV, Glybochko PV, Alyaev YuG, et al. Endoscopic enucleation of the prostate — a new standard in surgical treatment of benign prostatic hyperplasia. Andrology and Genital Surgery. 2017;18(3):83–88. (In Russ.) doi: 10.17650/2070-9781-2017-18-3-83-88
- Vartak KP, Raghuvanshi K. Outcome of thulium laser enucleation of prostate surgery in high-risk patients with benign prostatic hyperplasia. Urol Ann. 2019;11(4):358–362. doi: 10.4103/UA.UA_175_18
- Enikeev DV, Glybochko PV, Alyaev YuG, et al. Laser enucleation of the prostate (HOLEP and THULEP): a comparative effectiveness analysis in treating recurrent prostatic hyperplasia. Urologiia. 2017;(4):50–54. (In Russ.) doi: 10.18565/urol.2017.4.50-54
- Imkamp F, Bach T, Gross AJ, et al. ThuLEP-Thulium laser enucleation of the prostate. J Endourology. 2009;23(Suppl. 1):24–26.
- Gacci M, Gratzke C, Herrmann TRW, et al. Management of Non-neurogenic Male LUTS. EAU Guideline. Available from: https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts/chapter/disease-management
- Ketan PV, Prashant HS. Thulium laser enucleation of the prostate is a safe and a highly effective modality for the treatment of benign prostatic hyperplasia — Our experience of 236 patients. Urol Ann. 2016;8(1):76–80. doi: 10.4103/0974–7796.171494
- Bozzini G, Berti L, Maltagliati M, et al. Current evidence of ThuLEP for BPH: A review of literature. Turk J Urol. 2021;47(6):461–469. doi: 10.5152/tud.2021.21170
- Jones P, Rai BP, Somani BK, Aboumarzouk OM. A review of thulium laser vapo-enucleation of the prostate: A novel laser-based strategy for benign prostate enlargement. Arab J Urol. 2015;13(3):209–211. doi: 10.1016/j.aju.2015.06.007
- Raber M, Buchholz NNP, Vercesi A, et al. Thulium laser enucleation of the prostate (ThuLEP): Results, complications, and risk factors in 139 consecutive cases. Arab J Urol. 2018;16(4):411–416. doi: 10.1016/j.aju.2018.05.004
- Vydrin PS, Kalinina SN, Koren’kov DG. Assessment of blood flow in the prostate before and after transuretral enucleation of benign hyperplasia prostate. Urology reports (St. Petersburg). 2022;12(1): 63–70. doi: 10.17816/uroved105171
- Sun F, Sun X, Shi Q, Zhai Y. Transurethral procedures in the treatment of benign prostatic hyperplasia: A systematic review and meta-analysis of effectiveness and complications. Medicine (Baltimore). 2018;97(51): e13360. doi: 10.1097/MD.0000000000013360
Supplementary files
