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Original Research

How Is High Power (200w) Thulium Laser Vapoenucleation of the Prostate Impacting Functional Parameters? Short-Term Follow-Up Results


1 Department of Urology, Kafkas University, Medical School, Kars, Turkey
2 Department of Urology,Özel Sağlık Hospital, İzmir, Turkey
3 Department of Urology, Hatay Mustafa Kemal University, Medical School, Hatay, Turkey


DOI : 10.33719/yud.2023-18-3-1306328
New J Urol. 2023;18(3):240-248.

Abstract

Objective: There are limited studies in the literature analyzing the results of the high- power Thulium:YAG laser vapoenucleation technique. In this current study, it was aimed to examine the effectiveness and reliability of 200 W Thulium:YAG laser vapoenucleation used in the treatment of benign prostatic hyperplasia and the effect of this procedure on lower urinary tract symptoms, erectile and ejaculatory functions.

Material and Methods: Data were collected prospectively from patients who underwent Thulium vapoenucleation (ThuVEP) in our clinic between December 2021 and June 2022 to treat signs and symptoms of benign prostatic hyperplasia. Following the application of the exclusion criteria, a sample size of 50 cases was obtained, and the data were analyzed retrospectively. In the first and sixth months following surgery, all patients were compared to their preoperative status in terms of lower urinary tract symptoms, erectile function, and ejaculatory symptoms. The Modified Clavien- Dindo Classification was also used to classify the complications that occurred.

Results: The patients’ IPSS scores showed a notable and significant improvement at the end of the 6-month follow-up (27 vs. 5; p<0.001). When compared to the preoperative state, erectile functions as measured by the IIEF-5 score did not significantly change with the surgery (17 vs. 18; p=0.067). At the end of the follow-up period, there was a substantial deterioration of ejaculatory functions as measured by the MSHQ-EjD score (10 vs. 6.5; p<0.001). During and after the procedure, complications at the Clavien 3a level were seen in 2 (4%) of the patients, but no complications above this level were seen.

Conclusion: The high-power (200 W) ThuVEP method used in the surgical treatment of symptomatic benign prostatic hyperplasia is reliable and effective in terms of functional results according to short-term results.

Keywords: thulium, laser vaporization, impotence, lower urinary tract symptoms


Abstract

Objective: There are limited studies in the literature analyzing the results of the high- power Thulium:YAG laser vapoenucleation technique. In this current study, it was aimed to examine the effectiveness and reliability of 200 W Thulium:YAG laser vapoenucleation used in the treatment of benign prostatic hyperplasia and the effect of this procedure on lower urinary tract symptoms, erectile and ejaculatory functions.

Material and Methods: Data were collected prospectively from patients who underwent Thulium vapoenucleation (ThuVEP) in our clinic between December 2021 and June 2022 to treat signs and symptoms of benign prostatic hyperplasia. Following the application of the exclusion criteria, a sample size of 50 cases was obtained, and the data were analyzed retrospectively. In the first and sixth months following surgery, all patients were compared to their preoperative status in terms of lower urinary tract symptoms, erectile function, and ejaculatory symptoms. The Modified Clavien- Dindo Classification was also used to classify the complications that occurred.

Results: The patients’ IPSS scores showed a notable and significant improvement at the end of the 6-month follow-up (27 vs. 5; p<0.001). When compared to the preoperative state, erectile functions as measured by the IIEF-5 score did not significantly change with the surgery (17 vs. 18; p=0.067). At the end of the follow-up period, there was a substantial deterioration of ejaculatory functions as measured by the MSHQ-EjD score (10 vs. 6.5; p<0.001). During and after the procedure, complications at the Clavien 3a level were seen in 2 (4%) of the patients, but no complications above this level were seen.

Conclusion: The high-power (200 W) ThuVEP method used in the surgical treatment of symptomatic benign prostatic hyperplasia is reliable and effective in terms of functional results according to short-term results.

Keywords: thulium, laser vaporization, impotence, lower urinary tract symptoms

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