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Published in: World Journal of Urology 10/2017

01-10-2017 | Original Article

Five-year outcomes of thulium vapoenucleation of the prostate for symptomatic benign prostatic obstruction

Authors: A. J. Gross, A. K. Orywal, B. Becker, C. Netsch

Published in: World Journal of Urology | Issue 10/2017

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Abstract

Introduction and objectives

To assess the 5-year outcomes of thulium vapoenucleation of the prostate (ThuVEP) in patients with benign prostatic obstruction (BPO) retrospectively.

Methods

Five-hundred patients were treated with ThuVEP between January 2007 and January 2010 at our institution. Patients were reassessed 1 and 5-years after ThuVEP with International Prostate Symptom Score (IPSS), Quality of Life (QoL), urinary peak flow (Qmax), postvoid residual volume (PVR), PSA and prostate volume. Patient data were expressed as median (interquartile range).

Results

One-hundred and thirty-one patients completed the 5-year follow-up. According to preoperative prostate volume, patients were divided into two groups: group A (<60 ml, n = 80) and B (≥60 ml, n = 51). IPSS, QoL, Qmax, and PVR improved significantly at discharge and continued to do so during 5-year follow-up (p ≤ 0.001). At 1-year follow-up, prostate volume had decreased significantly (50 vs. 13 mL, p < 0.001) corresponding to a prostate volume reduction of 80.8%. PSA was significantly reduced at 5-year (0.72 µg/l) follow-up compared to preoperative PSA (3.39 µg/l, p ≤ 0.001). PSA-reduction (total 77.1%) at 5-year follow-up was significantly different between group A (70.2%) and B (83.5%) (p ≤ 0.006). IPSS was significantly lower in group B than in A (2.5 vs. 6, p < 0.001) at 5-year follow-up. Bladder neck contractures (n = 4) and urethral strictures (n = 4) occurred in 3.1% of the patients each. Three patients (2.3%) were re-treated for regrowth of prostatic tissue.

Conclusions

ThuVEP is a durable procedure with regard to micturition improvement and PSA-reduction. The reintervention rate after ThuVEP was low during long-term follow-up.
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Metadata
Title
Five-year outcomes of thulium vapoenucleation of the prostate for symptomatic benign prostatic obstruction
Authors
A. J. Gross
A. K. Orywal
B. Becker
C. Netsch
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 10/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-017-2034-4

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