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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Frontiers Media S.A.
2021-05-01
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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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publishDate | 2021-05-01 |
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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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