A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach

Background: Until recently, most enucleation techniques of the prostate were performed with the application of morcellator. We introduce a modified enucleation technique of thulium laser with non-morcellator approach, which is about incising and vaporizing remaining prostate tissue instead of a morc...

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Main Authors: Yifeng Jing, Qian Sun, Wenhuan Guo, Dapeng Zhou, Yiping Zhu, Yuyang Zhao, Di Cui, Xiaohai Wang, Yuan Ruan, Fujun Zhao, Shujie Xia, Bangmin Han
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-05-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2021.657869/full
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author Yifeng Jing
Qian Sun
Wenhuan Guo
Dapeng Zhou
Yiping Zhu
Yuyang Zhao
Di Cui
Xiaohai Wang
Yuan Ruan
Fujun Zhao
Shujie Xia
Bangmin Han
author_facet Yifeng Jing
Qian Sun
Wenhuan Guo
Dapeng Zhou
Yiping Zhu
Yuyang Zhao
Di Cui
Xiaohai Wang
Yuan Ruan
Fujun Zhao
Shujie Xia
Bangmin Han
author_sort Yifeng Jing
collection DOAJ
description Background: Until recently, most enucleation techniques of the prostate were performed with the application of morcellator. We introduce a modified enucleation technique of thulium laser with non-morcellator approach, which is about incising and vaporizing remaining prostate tissue instead of a morcellator.Methods: A retrospective evaluation of 223 patients undergoing ThuLEP from January 2014 to December 2015 was performed in our institution. One hundred five of the patients used morcellator while the other 118 used non-morcellator approach. All patients were assessed with the International Prostate Symptom Score (IPSS), quality of life (Qol), ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR). We reassessed these parameters at 1-, 3-, 6-, and 12-months after operation. Operative time, perioperative, and postoperative complications were also recorded.Results: Significant improvement was noted in the IPSS, QoL, Qmax, and PVR in both groups at the 12-month follow-up, and assessment showed no differences in these parameters between the two groups. Comparisons of the total operation time and enucleation time demonstrated no significant differences between the two groups. Our non-morcellator approach needed more time to incise and vaporize the enucleated tissue compared to morcellation when the prostate volume was about 40–80 ml (p < 0.05), while it showed a significant lower rate of superficial bladder injury than using morcellator (p < 0.05). There were no significant differences in other complications between the two groups (p > 0.05).Conclusions: Our modified technique is a safe and effective procedure for the treatment of BPH avoiding the potential complications caused by morcellator.
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spelling doaj.art-f8be1ad92374422e83396b215b17b2722022-12-21T21:59:18ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-05-01810.3389/fsurg.2021.657869657869A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator ApproachYifeng Jing0Qian Sun1Wenhuan Guo2Dapeng Zhou3Yiping Zhu4Yuyang Zhao5Di Cui6Xiaohai Wang7Yuan Ruan8Fujun Zhao9Shujie Xia10Bangmin Han11Department of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Urology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaBackground: Until recently, most enucleation techniques of the prostate were performed with the application of morcellator. We introduce a modified enucleation technique of thulium laser with non-morcellator approach, which is about incising and vaporizing remaining prostate tissue instead of a morcellator.Methods: A retrospective evaluation of 223 patients undergoing ThuLEP from January 2014 to December 2015 was performed in our institution. One hundred five of the patients used morcellator while the other 118 used non-morcellator approach. All patients were assessed with the International Prostate Symptom Score (IPSS), quality of life (Qol), ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR). We reassessed these parameters at 1-, 3-, 6-, and 12-months after operation. Operative time, perioperative, and postoperative complications were also recorded.Results: Significant improvement was noted in the IPSS, QoL, Qmax, and PVR in both groups at the 12-month follow-up, and assessment showed no differences in these parameters between the two groups. Comparisons of the total operation time and enucleation time demonstrated no significant differences between the two groups. Our non-morcellator approach needed more time to incise and vaporize the enucleated tissue compared to morcellation when the prostate volume was about 40–80 ml (p < 0.05), while it showed a significant lower rate of superficial bladder injury than using morcellator (p < 0.05). There were no significant differences in other complications between the two groups (p > 0.05).Conclusions: Our modified technique is a safe and effective procedure for the treatment of BPH avoiding the potential complications caused by morcellator.https://www.frontiersin.org/articles/10.3389/fsurg.2021.657869/fullbenign prostatic hyperplasiaenucleationmorcellatorthulium lasermodified technique
spellingShingle Yifeng Jing
Qian Sun
Wenhuan Guo
Dapeng Zhou
Yiping Zhu
Yuyang Zhao
Di Cui
Xiaohai Wang
Yuan Ruan
Fujun Zhao
Shujie Xia
Bangmin Han
A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach
Frontiers in Surgery
benign prostatic hyperplasia
enucleation
morcellator
thulium laser
modified technique
title A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach
title_full A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach
title_fullStr A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach
title_full_unstemmed A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach
title_short A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach
title_sort modified technique of thulium laser enucleation for benign prostatic hyperplasia with non morcellator approach
topic benign prostatic hyperplasia
enucleation
morcellator
thulium laser
modified technique
url https://www.frontiersin.org/articles/10.3389/fsurg.2021.657869/full
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