videour2014.

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Irritative symptoms after ThuLlium laser enucleation of the prostate (ThuLEP): our experience
Carmignani L, Picozzi S, Bozzini G, Casellato S, Finkelberg E, Marenghi C, Osmolovskiy° B, Kamalov° A
Academic Dep. Of Urology, University of Milan, Policlinico San Donato °Urology Department, Lomonosov Moscow State University

Aim Materials and methods Conclusion

A recent technological advance for the surgical treatment of
BOO has been the Thulium laser. The objective of the present
study was to definite the immediate irritative symptoms
following the endoscopic surgical treatments for benign
prostatic obstruction with the Thulium laser enucleation of the
prostate (ThuLEP).
Parameter Mean Range SD
A cooperation between the University of Milan and Moscow was
settled. From January 2012 to December 2013 we start a
prospective study on patients who underwent ThuLEP in order to
investigated the immediate post-operative irritative symptoms. All
candidates for surgical therapy present of lower urinary tract
symptoms (LUTS) and obstruction due to a prostate gland
enlargement. All these patients have LUTS refractory to medical
management. Thulium laser prostatectomy was performed by
Quanta Cyber TM Thulium Laser.
ThuLEP and the reduced depth of coagulation zone in the
prostate tissue could explain the reduction of these symptoms in
the immediate post-operatory period. So, the use of ThuLEP can
reduce the frustrating irritative symptoms in the immediate post-
operatory period, with equivalent results in the relief of LUTS and
uroflowmetry parameter in the long period follow-up.
Parameter Media DS

Age (y) 67,4 48-88 7,6 Results Operative time (min) 84 20

BMI 26 18,3-36,3 3,48 Resected weight (g) 18,27 15,8

200 patients performed the surgical treatment. The patients' mean
age was 67,4 years. Mean preoperative prostatic adenoma Preop hemoglobin (g/dl) 14,1 1,18
Vol Prostate (ml) 78 14-235 43,1
volume was 78 mL. Forty-six of the patients have an indwelling
urethral catheter. Mean total operative time, including cystoscopy, Postop hemoglobin (g/dl) 12,8 1,42
Vol Adenom (ml) 44,7 7-167 31,4 enucleation and morcellation was 84 min. The average Foley
catheter-time was respectively of 36 hours. IPSS, QoL and F Max Hemoglobin decrease (g/dl) - 1,3 1,91
PSA (ng/dl) 3,5 0,12-18,72 3,1 improvement don’t vary considering prostate volume, the
presence of an indwelling urethral catheter and a significant PVR.
Transfusion rate (%) 1,5
In all, 4% of the patients reported urge incontinence 7 days after
Dysuria (y) 5,7 1-20 4,5 the procedure that reduce to 0,5 % at 30 days after the procedure
Catheterization time (day) 1,53 1,11
and disappeared in the follow-up period. Urgency was present in
CV (n°) 46 the 12% of the patients 7 days after the procedure that reduce to 5 2,47 1,49
% at 30 days after the procedure and disappeared in the follow-up Hospital stay (day)
CV (months) 3,6 0,3-15 3,76 period. Mean follow-up was of 14 months (range 1-24 months).
The result in reduction of IPSS, improvement of QoL, F Max were
maintained in time.