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This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery

Open Access Research article

Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients

Fabrizio Iacono1*, Domenico Prezioso1, Giovanni Di Lauro2, Giuseppe Romeo1, Antonio Ruffo1, Ester Illiano1 and Bruno Amato3

Author Affiliations

1 Department of Urology, School of Medicine, University “Federico II” of Naples, Via pasini, 5 – 80131 – Naples, Italy

2 Department of Urology, Hospital S.Maria delle Grazie of Pozzuoli (Na), Via Domiziana – 80078 – Pozzuoli (Na), Italy

3 Department of General, Geriatric, Oncological Surgery and Advanced Technologies, University “Federico II” of Naples. Via Pasini, 5 – 80131 – Naples, Italy

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BMC Surgery 2012, 12(Suppl 1):S21  doi:10.1186/1471-2482-12-S1-S21

Published: 15 November 2012

Abstract

Background

Over the past years laser technology has played a predominant role in prostate surgery, for the treatment of benign prostate hypertrophy (BPH). Various laser devices have been introduced in clinical practice, showing good results in terms of complications and urodynamic outcomes efficacy compared with TURP and Open Prostatectomy.

In this study we describe the efficacy and the safety profile of a novel laser technique, ThuLEP (Thulium Laser Enucleation of Prostate) that permits a complete anatomical endoscopic enucleation of prostatic adenoma independently to prostate size.

Methods

148 patients with a mean age of 68.2 years were enrolled between September 2009 and March 2012 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), International Index of Erectile Function-5 (IIEF-5), Quality of Life (QoL), PSA values, urine analysis and urine culture, uroflowmetry. The same evaluation was conducted after a 12 month follow-up. ThuLEP was performed by 2 expert surgeons.

Results

Our data showed a better post-operative outcome in terms of catheter removal, blood loss, TURP syndrome, clot retention and residual tissue compared to large series of TURP and OP. Only 1.3% of patients had bladder wall injury during morcellation. I-PSS, Qmax, Prostate Volume, QoL and PVR showed a highly significant improvement at 12 month follow-up in comparison to preoperative assessment.

Conclusion

ThuLEP represent an innovative option in patients with BPH. It is a size independent surgical endoscopic technique and it can be considered the real alternative, at this time, to TURP and even more to Open Prostatectomy for large prostate, with a complete removal of adenoma and with a low complication rate.