Skip to main content

Advertisement

SpringerLink
Log in

Transurethral vaporesection of prostate: diode laser or thulium laser?

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

This study compared the safety and effectiveness of the diode laser and thulium laser during prostate transurethral vaporesection for treating benign prostate hyperplasia (BPH). We retrospectively analyzed 205 patients with BPH who underwent a diode laser or thulium laser technique for prostate transurethral vaporesection from June 2016 to June 2017 and who were followed up for 3 months. Baseline characteristics of the patients, perioperative data, postoperative outcomes, and complications were compared. We also assessed the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax), average flow rate (AFR), and postvoid residual volume (PVR) at 1 and 3 months postoperatively to evaluate the functional improvement of each group. There were no significant differences between the diode laser and thulium laser groups related to age, prostate volume, operative time, postoperative hospital stays, hospitalization costs, or perioperative data. The catheterization time was 3.5 ± 0.8 days for the diode laser group and 4.7 ± 1.8 days for the thulium laser group (p < 0.05). Each group had dramatic improvements in IPSS, QoL, Qmax, AFR, and PVR compared with the preoperative values (p < 0.05), although there were no significant differences between the two groups. Use of both diode laser and thulium laser contributes to safe, effective transurethral vaporesection in patients with symptomatic BPH. Diode laser, however, is better than thulium laser for prostate transurethral vaporesection because of its shorter catheterization time. The choice of surgical approach is more important than the choice of laser types during clinical decision making for transurethral laser prostatectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Zhang X, Zeng X, Liu Y, Dong L, Zhao X, Qu X (2014) Impact of metabolic syndrome on benign prostatic hyperplasia in elderly Chinese men. Urol Int 93(2):214–219

    Article  CAS  PubMed  Google Scholar 

  2. Yin Z, Yang JR, Rao JM, Song W, Zhou KQ (2015) Association between benign prostatic hyperplasia, body mass index, and metabolic syndrome in Chinese men. ASIAN J ANDROL 17(5):826–830

    PubMed  PubMed Central  Google Scholar 

  3. He LY, Zhang YC, He JL, Li LX, Wang Y, Tang J, Tan J, Zhong K, Tang YX, Long Z (2016) The effect of immediate surgical bipolar plasmakinetic transurethral resection of the prostate on prostatic hyperplasia with acute urinary retention. ASIAN J ANDROL 18(1):134–139

    Article  PubMed  Google Scholar 

  4. Nair SM, Pimentel MA, Gilling PJ (2016) A review of laser treatment for symptomatic BPH (benign prostatic hyperplasia). CURR UROL REP 17(6)

  5. Gravas S, Bach T, Bachmann A, Drake M, Gacci M, Gratzke C, Madersbacher S, Mamoulakis C, Tikkinen KAO Management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO). European Assoc Urology Guidelines 2016*ed 2016:32

  6. Takada J, Honda N, Hazama H, Ioritani N, Awazu K (2016) Analysis of thermally denatured depth in laser vaporization for benign prostatic hyperplasia using a simulation of light propagation and heat transfer (secondary publication). LASER THERAPY 25(4):273–284

    Article  PubMed  PubMed Central  Google Scholar 

  7. Fu WJ, Hong BF, Yang Y, Zhang X, Gao JP, Zhang L, Wang XX (2009) Vaporesection for managing benign prostatic hyperplasia using a 2-microm continuous-wave laser: a prospective trial with 1-year follow-up. BJU Int 103(3):352–356

    Article  PubMed  Google Scholar 

  8. Xia SJ, Zhuo J, Sun XW, Han BM, Shao Y, Zhang YN (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 53(2):382–389

    Article  PubMed  Google Scholar 

  9. Long Z, Zhang YC, He LY, Zhong KB, Tang YX, Huang K (2014) Comparison of transurethral plasmakinetic and transvesical prostatectomy in treatment of 100-149 mL benign prostatic hyperplasia. ASIAN J SURG 37(2):58–64

    Article  PubMed  Google Scholar 

  10. Leonardi R (2009) Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique. Prostate Cancer Prostatic Dis 12(3):277–280

    Article  CAS  PubMed  Google Scholar 

  11. Zhao Y, Liu C, Zhou G, Yu C, Zhang Y, Ouyang Y (2013) A retrospective evaluation of benign prostatic hyperplasia treatment by transurethral vaporization using a 1470 nm laser. Photomed Laser Surg 31(12):626–629

    Article  PubMed  Google Scholar 

  12. Herrmann TR, Bach T, Imkamp F, Georgiou A, Burchardt M, Oelke M, Gross AJ (2010) Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. Introduction of a novel technique for the treatment of benign prostatic obstruction. World J Urol 28(1):45–51

    Article  PubMed  Google Scholar 

  13. Kim Y, Seong YK, Kim IG, Han BH (2013) Twelve-month follow-up results of photoselective vaporization of the prostate with a 980-nm diode laser for treatment of benign hyperplasia. Korean J Urology 54(10):677

    Article  Google Scholar 

  14. JIANG H, ZHOU Y (2016) Safety and efficacy of thulium laser prostatectomy versus transurethral resection of prostate for treatment of benign prostate hyperplasia: a meta-analysis. LUTS: Lower Urinary Tract Symptoms 8(3):165–170

    CAS  PubMed  Google Scholar 

  15. Lee WC, Lin YH, Hou CP, Chang PL, Chen CL, Juang HH, Tsui KH (2013) Prostatectomy using different lasers for the treatment of benign prostate hyperplasia in aging males. Clin Interv Aging 8:1483–1488

    PubMed  PubMed Central  Google Scholar 

  16. Erol A, Cam K, Tekin A, Memik O, Coban S, Ozer Y (2009) High power diode laser vaporization of the prostate: preliminary results for benign prostatic hyperplasia. J Urol 182(3):1078–1082

    Article  CAS  PubMed  Google Scholar 

  17. Barbalat Y, Velez MC, Sayegh CI, Chung DE (2016) Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction. Ther Adv Urol 8(3):181–191

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Razzaghi MR, Mazloomfard MM, Mokhtarpour H, Moeini A (2014) Diode laser (980 nm) vaporization in comparison with transurethral resection of the prostate for benign prostatic hyperplasia: randomized clinical trial with 2-year follow-up. Urology 84(3):526–532

    Article  PubMed  Google Scholar 

  19. Xu A, Zou Y, Li B, Liu C, Zheng S, Li H, Xu Y, Chen B, Xu K, Shen H (2013) A randomized trial comparing diode laser enucleation of the prostate with plasmakinetic enucleation and resection of the prostate for the treatment of benign prostatic hyperplasia. J Endourol 27(10):1254–1260

    Article  PubMed  Google Scholar 

  20. Wang L, Yu QY, Liu Y, Zhu ZL, Huang YW, Li K (2016) Efficacy and safety of laser surgery and transurethral resection of the prostate for treating benign prostate hyperplasia: a network meta-analysis. Asian Pac J Cancer Prev 17(9):4281–4288

    PubMed  Google Scholar 

  21. Seitz M, Ackermann A, Gratzke C, Schlenker B, Ruszat R, Bachmann A, Stief C, Reich O, Sroka R (2007) Diode laser. Ex vivo studies on vaporization and coagulation characteristics. Urologe A 46(9):1242–1247

    Article  CAS  PubMed  Google Scholar 

  22. Nafie S, Dormer J, Khan MA (2017) The significance of histological analysis following laser transurethral resection of the prostate. Int Urol Nephrol 49(8):1343–1346

    Article  CAS  PubMed  Google Scholar 

  23. Skinner T, Leslie RJ, Steele SS, Nickel JC (2017) Randomized, controlled trial of laser vs. bipolar plasma vaporization treatment of benign prostatic hyperplasia. Can Urol Assoc J 11(6):194–198

    Article  PubMed  PubMed Central  Google Scholar 

  24. Zhang X, Shen P, He Q, Yin X, Chen Z, Gui H, Shu K, Tang Q, Yang Y, Pan X, Wang J, Chen N, Zeng H (2016) Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis. SCI REP-UK 6(1):23503

    Article  CAS  Google Scholar 

  25. Peng M, Yi L, Wang Y (2016) Photoselective vaporization of the prostate vs plasmakinetic resection of the prostate: a randomized prospective trial with 12-month follow-up in mainland China. Urology 87:161–165

    Article  PubMed  Google Scholar 

  26. Li D, Jiang X, Zhang X, Yi L, Zhu X, Zeng X, Guo X, Tang Y (2012) Multicenter pathophysiologic investigation of erectile dysfunction in clinic outpatients in China. Urology 79(3):601–606

    Article  PubMed  Google Scholar 

Download references

Funding

This study was supported by the Natural Science Foundation of Hunan Province (Grant No. 14JJ7004) and Innovation Foundation For Postgraduate of Central South University (Grant No. 2017zzts887).

Author information

Authors and Affiliations

  1. Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, 41008, Hunan, China

    Xinji Tan, Xiaobo Zhang, Dongjie Li, Xiong Chen, Jie Gu, Mingquan Chen, Sheng Hu & Yao Bai

  2. The Department of Geriatric Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Xinji Tan, Xiaobo Zhang, Yuanqing Dai, Jie Gu, Mingquan Chen, Sheng Hu & Yao Bai

  3. Urolithiasis Institute of Central South University, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Xiaobo Zhang

  4. The Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Xiaobo Zhang & Yao Bai

  5. The Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, China

    Yu Ning

Authors
  1. Xinji Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiaobo Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dongjie Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuanqing Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jie Gu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mingquan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sheng Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yao Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yu Ning
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiaobo Zhang.

Ethics declarations

Financial disclosure

The study was supported by the Natural Science Foundation of Hunan Province (Grant No. 14JJ7004) and Innovation Foundation For Postgraduate of Central South University (Grant No. 2017zzts887).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

Electronic supplementary material

ESM 1

(DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tan, X., Zhang, X., Li, D. et al. Transurethral vaporesection of prostate: diode laser or thulium laser?. Lasers Med Sci 33, 891–897 (2018). https://doi.org/10.1007/s10103-018-2499-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-018-2499-4

Keywords

Search

Navigation