Efficacy and Safety of 120-W Thulium:Yttrium-Aluminum-Garnet Vapoenucleation of Prostates Compared with Holmium Laser Enucleation of Prostates for Benign Prostatic Hyperplasia

摘要

Background:This study compared the efficacy and safety between 120-W thulium:yttrium-aluminum-garnet (Tm:YAG) vapoenucleation of prostates (ThuVEP) and holmium laser enucleation of prostates (HoLEP) for patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).Methods:A retrospective analysis of 88 consecutive patients with symptomatic BPH was carried out,who underwent either 120-W ThuVEP or HoLEP nonrandomly.Patient demographics and peri-operative and 12-month follow-up data were analyzed with the International Prostate Symptom Score (IPSS),quality of life (QoL) score,maximum flow rate (Qmax),postvoid residual urine volume (PVR),and rates of peri-operative and late complications.Results:The patients in each group showed no significant difference in preoperative parameters.Compared with the HoLEP group,patients in the 120-W ThuVEP group required significantly shorter time for laser enucleation (58.3 ± 12.8 min vs.70.5 ± 22.3 min,P =0.003),and resulted in a significant superiority in laser efficiency (resected prostate weight/laser enucleation time) for 120-W Tm:YAG lasercompared to holmium:YAG laser (0.69 ± 0.18 vs.0.61 ± 0.19,P =0.048).During 1,6,and 12 months of follow-ups,the procedures did not demonstrate a significant difference in IPSS,QoL score,Qmax,or PVR (P ＞ 0.05).Mean peri-operative decrease of hemoglobin in the HoLEP group was similar to the ThuVEP group (17.1 ± 12.0 g/L vs.15.2 ± 10.1 g/L,P =0.415).Early and late incidences of complications were low and did not differ significantly between the two groups of 120-W ThuVEP and HoLEP patients (P ＞ 0.05).Conclusions:120-W ThuVEP and HoLEP are potent,safe and efficient modalities of minimally invasive surgeries for patients with LUTS due to BPH.Compared with HoLEP,120-W ThuVEP offers advantages of reduction of laser enucleation time and improvement of laser efficiency.