T hulium Laser VapoEnucleation of the Prostate for the Treatment of Benign Prostatic Obstruction

1. No. 033 Thulium Laser VapoEnucleation of the Prostate for the Treatment of Benign Prostatic Obstruction Amanda Chung1, Mya Thida2, Owen Kang2, Hodo Haxhimolla2. 1The Canberra Hospital, Garran, ACT, Australia; 2Australian National University, Acton, ACT, Australia. Posters Proudly Supported by: • Results • Study Population • Of 56 men; • Median patient age = 69.5 year (range 48 – 91) • Median prostate volume = 61cc (IQR 41 – 82) • 34% (19/56) men were in urinary retention. This was managed by; • Intermittent self catheterisation – in 1 man • Urethral catheter – in 11 men • Suprapubic catheter – in 7 men. • 34% (19/56) men were taking antiplatelet and/or anticoagulant medication. This consisted of; • Aspirin only – in 12 men • Warfarin only – in 5 men • Aspirin and clopidogrel – in 2 men. • Perioperative Outcomes • Perioperative outcomes were recorded, and are outlined in table 1. • Functional Outcomes • 89% (50/56) men voided successfully and went home catheter-free. • 98% (55/56) were catheter-free by 3 months. • IPSS, QoL and Qmax improved significantly (p<0.01), as outlined in table 2. • Complications • 18% (10/56) men experienced at least 1 complication. • There were 13 complications, as outlined in table 3. Introduction Laser technologies, such as thulium, and prostatectomy techniques, such as vapo-enucleation, are gaining popularity in the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO). Early studies suggest that Thulium laser VapoEnucleation of the Prostate (ThuVEP) is a promising treatment for BPO, but the number of published reports in the literature is sparse. Aim The aim of this study is to evaluate the safety and efficacy of ThuVEP using the 70W thulium:yttrium-aluminium-garnet (Tm:YAG) laser in the treatment of men with LUTS due to BPO. • Methods A prospective database of all 56 men treated with ThuVEP using a 70W 2013nm continuous-wave Tm:YAG laser by a single surgeon, from January 2012 to August 2012, was maintained. Perioperative outcomes were recorded. These included; • Operating time • Laser time • Energy usage • Duration of catheterisation • Duration of hospital stay. • Functional outcomes were assessed at baseline and at 3-6 months follow-up. These included; • International Prostate Symptom Score (IPSS) • Quality of Life (QoL) • Maximum urinary flow rate (Qmax) • Post void residual urine (PVR). • Statistical analyses were performed in Microsoft Excel 2011, and comparisons were evaluated using Student’s t-test. Table 1. Perioperative outcomes. Table 2. Functional outcomes. Conclusions ThuVEP using the 70W Tm:YAG laser is an efficacious and safe treatment for men with LUTS due to BPO. Reference 1. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240: 205-13. Table 3. Complications classified by Clavien-Dindo grade1.