Pulsed-wave vs Continuous-wave Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP): A Comparison of Perioperative Outcomes.


Journal

Urology
ISSN: 1527-9995
Titre abrégé: Urology
Pays: United States
ID NLM: 0366151

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 27 11 2022
revised: 07 04 2023
accepted: 16 05 2023
medline: 28 8 2023
pubmed: 1 6 2023
entrez: 31 5 2023
Statut: ppublish

Résumé

To compare intra and early postoperative outcomes between pulsed-wave and continuous-wave Thulium Fiber Laser Enucleation of the Prostate (PW-ThuFLEP vs CW-ThuFLEP) for the treatment of benign prostatic hyperplasia. 238 patients with lower urinary tract symptoms due to benign prostatic hyperplasia underwent PW-ThuFLEP (118 patients) vs CW-ThuFLEP (120 patients). Preoperative prostate volume, adenoma volume, prostate-specific antigen (PSA), and hemoglobin values were recorded. International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-void residual volume, and International Index of Erectile Function-5 score (IIEF-5) were assessed. Operative time, enucleation time, enucleation efficiency, catheterization time, irrigation volume, hospital stay, hemoglobin drop, and postoperative complications were recorded. Micturition improvements and sexual outcomes were evaluated 3months after surgery. CW-ThuFLEP showed shorter operative time (61.5 vs 67.4 minutes, P = .04). Enucleation time (50.2 vs 53.3 minutes, P = .12), enucleation efficiency (0.8 vs 0.7 g/min, P = .38), catheterization time (2.2 vs 2.1days, P = .29), irrigation volume (32.9 vs 32.8L, P = .71), hospital stay (2.8 vs 2.6days, P = .29) and hemoglobin drop (0.38 vs 0.39 g/dL, P = .53) were comparable. No significant difference in complication rate was observed. At 3-month follow-up, the procedures did not show any significant difference in IPSS, Qmax, post-void residual volume, IIEF-5, and PSA value. PW-ThuFLEP and CW-ThuFLEP both relieve lower urinary tract symptoms equally, with high efficacy and safety. Operative time was significantly shorter with CW-ThuFLEP, but with a small difference with low clinical impact. Enucleation time, enucleation efficiency, catheterization time, irrigation volume, hospital stay, hemoglobin and PSA drop, complication rate, and sexual outcomes showed no differences.

Identifiants

pubmed: 37257589
pii: S0090-4295(23)00449-1
doi: 10.1016/j.urology.2023.05.013
pii:
doi:

Substances chimiques

Thulium 8RKC5ATI4P
Prostate-Specific Antigen EC 3.4.21.77

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

120-124

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

DECLARATION OF COMPETING INTEREST None.

Auteurs

D Perri (D)

Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy. Electronic address: perri.davide90@gmail.com.

F Mazzoleni (F)

Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy.

U Besana (U)

Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy.

A Pacchetti (A)

Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy.

E Morini (E)

Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy.

L Berti (L)

Department of Urology, ASST Valle Olona, Busto Arsizio Hospital, Busto Arsizio, Italy.

M Calandriello (M)

Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy.

A L Pastore (AL)

Department of Urology, Sapienza University of Rome, Latina, Italy.

J Romero-Otero (J)

Department of Urology, Hospital Universitario HM Montepríncipe, Madrid, Spain.

F Bruyere (F)

Department of Urology, CHRU Bretonneau, Tours, France.

M C Sighinolfi (MC)

Department of Urology, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy.

B Rocco (B)

Department of Urology, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy.

S Micali (S)

Department of Urology, Modena and Reggio Emilia University, Modena, Italy.

A S Gozen (AS)

Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany.

E Liatsikos (E)

Department of Urology, University of Patras, Patras, Greece.

J B Roche (JB)

Department of Urology, Clinique Saint Augustin, Bordeaux, France.

G Bozzini (G)

Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy.

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Classifications MeSH