Abstract
Introduction: Benign prostatic enlargement has been a major part of urology and its treatment has been challenged by numerous technologies arising as the years go by. TURP remains a standard in comparison to new techniques that has been introduced. Recently laser, specifically thulium:yag, has been found to be a promising contender for TURP.
Techniques: Two techniques are available when using thulium:yag laser for the benign prostate. It includes laser enucleation which involves the use of a morcellator and vaporesection which is done if the morcellator is not available.
Outcomes and complications: Based on numerous studies, outcomes and complication rates of TLRP compared to that of TURP is very much comparable.
Conclusion and recommendations: TLRP is relatively safe and practical and offers a good alternative to TURP. Results from various studies with this new laser technology are encouraging.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Alsaywid BS, Smith GHH. Antibiotic prophylaxis for transurethral urological surgeries: systematic review. Urol Ann. 2013;5(2):61–74.
Carmignani L, et al. One day surgery in the treatment of benign prostatic enlargement with thulium laser: a single institution experience. Korean J Urol. 2015;56(5):365–9.
Chung DE, Te AE. New techniques for laser prostatectomy: an update. Ther Adv Urol. 2009;1:85–97.
EAU. Guidelines on non neurogenic male LUTS. 2017.
Fried NM, Murray KE. High-power thulium fiber laser ablation of urinary tissues at 1.94 micron. J Endourol. 2005;19:25–31.
Gross A, Netsch C, Knipper S, Hölzel J, Bach T. Complications and early postoperative outcome in 1080 patients after thulium vapoenucleation of the prostate: results at a single institution. Euro Urol. 2013;63:859–67.
Hong D, et al. Comparison between thulium laser resection of prostate and transurethral plasmakinetic resection of prostate or transurethral resection of prostate. Sci Rep. 2015;5:14542. https://doi.org/10.1038/srep14542.
Iacono F, et al. 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. BMC Surg. 2012;12:1471–2.
Kim JW, et al. An analytical comparison of short-term effectiveness and safety between Thulium:YAG laser vaporesection of the prostate and bipolar transurethral resection of the prostate in patients with benign prostatic hyperplasia. Korean J Urol. 2014;55(1):41–6.
Lerner LB, Rajender A. Laser prostate enucleation techniques. Can J Urol. 2015;22(Suppl 1):53–9.
Mrkobrada M, Ying I, Mokrycke S, Dresser G, Elsayed S, Bathini V, Boyce E, Luke P. CUA guidelines on antibiotic prophylaxis for urologic procedures. Can Urol Assoc J. 2015;9(1–2):13–22.
Netsch C, Engbert A, Bach T, Gross A. Long-term outcome following Thulium VapoEnucleation of the prostate. World J Urol. 2014;32(6):1551–8. https://doi.org/10.1007/s00345-014-1260-2.
Rausch S, Heider T, Bedke J, et al. Analysis of early morbidity and functional outcome of thulium:yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome. Urology. 2015;85(1):182–8.
Stuart Wolf Jr J, et al. Urologic surgery antimicrobial prophylaxis. Am Urol Assoc. 2016.
Swiniarski P, Stepien S, Dudzic W, et al. Thulium laser enucleation of the prostate (TmLEP) vs. transurethral resection of the prostate (TURP): evaluation of early results. Cent Euro J Urol. 2012;65(3):130–4.
Szlauer R, Götschl R, Razmaria A, Paras L, Schmeller NT. Endoscopic vaporesection of the prostate using the continuouswave 2-μm thulium laser: outcome and demonstration of the surgical technique. Euro Urol. 2009;55:368–75.
Szlauer R, et al. Endoscopic vaporesection of the prostate using the continuous-wave 2-microm thulium laser: outcome and demonstration of the surgical technique. Eur Urol. 2009;55(2):368–75. https://doi.org/10.1016/j.eururo.2008.10.034. Epub 2008 Nov 12.
Tang K, et al. Early outcomes of thulium laser versus transurethral resection of the prostate for managing benign prostatic hyperplasia: a systematic review and meta-analysis of comparative studies. J Endourol. 2014;28(1):65–72. https://doi.org/10.1089/end.2013.0404. Epub 2013 Nov 4.
Vartak Ketan P, et al. Thulium laser enucleation of the prostate is a safe and a highly effective modality for the treatment of benign prostatic hyperplasia: our experience of 236 patients. Urol Ann. 2016;8(1):76–80.
Wendt-Nordahl G, et al. Systematic evaluation of a recently introduced 2-microm continuous-wave thulium laser for vaporesection of the prostate. J Endourol. 2008;22:1041–5.
Worthington J, et al. A randomised controlled trial to determine the clinical and cost effectiveness of thulium laser transurethral vaporesection of the prostate (ThuVARP) versus transurethral resection of the prostate (TURP) in the National Health Service (NHS)—the UNBLOCS trial: a study protocol for a randomised controlled trial. Trials. 2017;18(1):179.
Yan H, et al. Thulium laser vaporesection versus standard transurethral resection of the prostate: a randomized trial with transpulmonary thermodilution hemodynamic monitoring. Int J Urol. 2013;20(5):507–12.
Yang Z, Wang X, Liu T. Thulium laser enucleation versus plasmakinetic resection of the prostate: a randomized prospective trial with 18-month follow-up. Urology. 2013;81(2):396–400.
Zhang F, Shao Q, Herrmann T, Tian Y, Zhang Y. Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center. Urology. 2012;79(4):869–74.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Tan, K.M.M., Sergio, S.C., Romero, R.L.T. (2019). Thulium: YAG Laser Resection for Benign Prostatic Enlargement. In: Chan, Ey., Matsuda, T. (eds) Endourology Progress. Springer, Singapore. https://doi.org/10.1007/978-981-13-3465-8_31
Download citation
DOI: https://doi.org/10.1007/978-981-13-3465-8_31
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-3464-1
Online ISBN: 978-981-13-3465-8
eBook Packages: MedicineMedicine (R0)