Experts' recommendations in laser use for the endoscopic treatment of prostate hypertrophy: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training-Research in Urological Surgery and Technology (T.R.U.S.T.)-Group.

Male Humans Lithotripsy, Laser / methods Prostatic Hyperplasia / surgery Prostate Lasers, Solid-State / therapeutic use Hypertrophy / drug therapy Thulium / therapeutic use Laser Therapy / methods
Laser Prostat* hyperplasia Prostat* hypertrophy Settings Survey

Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 02 07 2023
accepted: 01 08 2023
medline: 9 11 2023
pubmed: 27 8 2023
entrez: 26 8 2023
Statut: ppublish

Résumé

To identify expert laser settings for BPH treatment and evaluate the application of preventive measures to reduce complications. A survey was conducted after narrative literature research to identify relevant questions regarding laser use for BPH treatment (59 questions). Experts were asked for laser settings during specific clinical scenarios. Settings were compared for the reported laser types, and common settings and preventive measures were identified. Twenty-two experts completed the survey with a mean filling time of 12.9 min. Ho:YAG, Thulium fiber laser (TFL), continuous wave (cw) Tm:YAG, pulsed Tm:YAG and Greenlight™ lasers are used by 73% (16/22), 50% (11/22), 23% (5/22), 13.6% (3/22) and 9.1% (2/22) of experts, respectively. All experts use anatomical enucleation of the prostate (EEP), preferentially in one- or two-lobe technique. Laser settings differ significantly between laser types, with median laser power for apical/main gland EEP of 75/94 W, 60/60 W, 100/100 W, 100/100 W, and 80/80 W for Ho:YAG, TFL, cwTm:YAG, pulsed Tm:YAG and Greenlight™ lasers, respectively (p = 0.02 and p = 0.005). However, power settings within the same laser source are similar. Pulse shapes for main gland EEP significantly differ between lasers with long and pulse shape modified (e.g., Moses, Virtual Basket) modes preferred for Ho:YAG and short pulse modes for TFL (p = 0.031). Ho:YAG lasers no longer seem to be the mainstay of EEP. TFL lasers are generally used in pulsed mode though clinical applicability for quasi-continuous settings has recently been demonstrated. One and two-lobe techniques are beneficial regarding operative time and are used by most experts.

Identifiants

DOI: 10.1007/s00345-023-04565-y PMID: 37632557
pubmed: 37632557
doi: 10.1007/s00345-023-04565-y
pii: 10.1007/s00345-023-04565-y
doi:

Substances chimiques

Thulium 8RKC5ATI4P

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3277-3285

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Gernot Ortner (G)

Department of Urology and Andrology, General Hospital Hall i.T., Hall in Tirol, Austria. gerni_o@hotmail.com.
Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria. gerni_o@hotmail.com.
ORCID: 0000-0002-2454-6599

Selcuk Güven (S)

Department of Urology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.

Bhaskar Kumar Somani (BK)

Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Andre Nicklas (A)

Department of Urology and Andrology, General Hospital Hall i.T., Hall in Tirol, Austria.
Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.

Cesare Marco Scoffone (CM)

Department of Urology, Cottolengo Hospital of Torino, Turin, Italy.

Cecilia Gracco (C)

Department of Urology, Cottolengo Hospital of Torino, Turin, Italy.

Ioannis Kartalas Goumas (IK)

Department of Urology, Istituto Clinico Beato Matteo, Vigevano, Italy.

Thorsten Bach (T)

Department of Urology, Asklepios Westklinikum Rissen, Hamburg, Germany.

Fernando Gómez Sancha (FG)

Department of Urology, ICUA-Clínica CEMTRO, Madrid, Spain.

Felipe C A Figueredo (FCA)

Instituto da Próstata Aumentada, Hospital Pompéia, Caxias do Sul, Brazil.

Amy Krambeck (A)

Department of Urology, Northwestern Medicine, Chicago, IL, USA.

Giorgio Bozzini (G)

Department of Urology, ASST Lariana, Como, Italy.

Karin Lehrich (K)

Department of Urology, Urological Laser Center, Vivantes Auguste-Viktoria-Hospital Berlin, Berlin, Germany.

Evangelos Liatsikos (E)

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

Panagiotis Kallidonis (P)

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

Jean Baptiste Roche (JB)

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

Arkadiusz Miernik (A)

Department of Urology, University of Freiburg, Freiburg, Germany.

Dmitry Enikeev (D)

Department of Urology, Medical University of Vienna, Vienna, Austria.
Karl Landstainer Institute of Urology and Andrology, Vienna, Austria.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Lutfi Tunc (L)

Department of Urology, Acibadem Hospital, Ankara, Turkey.

Naeem Bhojani (N)

Division of Urology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montreal, QC, Canada.

Peter Gilling (P)

Department of Urology, Tauranga Hospital, University of Auckland, Auckland, New Zealand.

Javier Romero Otero (JR)

ROC Clinic and HM Urological Department, Fundación Investigación HM Hospitales, HM Hospitales, Madrid, Spain.

Angelo Porreca (A)

Department of Oncological Urology, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy.

Sasha Ahyai (S)

Department of Urology, Medical University of Graz, Graz, Austria.

Christopher Netsch (C)

Department of Urology, Asklepios Klinik Barmbek, Hamburg, Germany.

Ali Serdar Gözen (AS)

Department of Urology, Medius Kliniken, Ruit, Baden-Württemberg, Germany.

Udo Nagele (U)

Department of Urology and Andrology, General Hospital Hall i.T., Hall in Tirol, Austria.
Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.

Thomas R W Herrmann (TRW)

Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland.

Theodoros Tokas (T)

Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Heraklion, Greece.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Experts' recommendations in laser use for the...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie par ultrasons › Lithotritie › Lithotritie par laser › Experts' recommendations in laser use for the...
questionsmedicales.fr › Maladies urogénitales › Maladies urogénitales de l'homme › Maladies de l'appareil génital mâle › Maladies de la prostate › Hyperplasie de la prostate › Experts' recommendations in laser use for the...
questionsmedicales.fr › Tissus › Glandes exocrines › Prostate › Experts' recommendations in laser use for the...
questionsmedicales.fr › Équipement et fournitures › Équipement et fournitures pour les applications des radiations › Lasers › Lasers à solide › Experts' recommendations in laser use for the...
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Hypertrophie › Experts' recommendations in laser use for the...
questionsmedicales.fr › Produits chimiques inorganiques › Métaux › Terres rares › Lanthanides › Thulium › Experts' recommendations in laser use for the...
questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques d'ablation › Thérapie laser › Experts' recommendations in laser use for the...