Safety and Effectiveness of Thulium VapoEnucleation of the Prostate (ThuVEP) in Patients on Anticoagulant Therapy

Overview

Journal World J Urol

Specialty Urology

Date 2013 May 10

PMID 23657354

Citations 15

Authors

Christopher Netsch

M Stoehrer

M Bruning

A Gabuev

T Bach

T R W Herrmann

A J Gross

Affiliations

Soon will be listed here.

Abstract

Introduction: To evaluate the safety and efficacy of Thulium VapoEnucleation of the prostate (ThuVEP) for patients on oral anticoagulants (OA) with symptomatic benign prostatic obstruction (BPO).

Methods: Fifty-six patients, undergoing ThuVEP at two institutions, were evaluated from May 2009 until June 2011. All patients were at high cardiopulmonary risk and presented with a median American Society of Anesthesiology score of 3 [interquartile range (IQR) 2-3]. Thirty-two patients were on aspirin, 8 were on clopidogrel or clopidogrel and aspirin, and 16 on phenprocoumon at the time of surgery. Patient demographic, perioperative, and follow-up data were analyzed.

Results: Median prostate volume was 50 (IQR 34-76) cc, and resected tissue weight was 32 (IQR 20-50) g. The median operative time was 61.5 (IQR 40-100.75) min, and the catheter time 2 (IQR 2-3) days. There were no perioperative thromboembolic events. Five patients (8.9%) required a second-look operation in the immediate postoperative course (hemorrhage n = 4, residual adenoma n = 1) and four (7.1%) blood transfusions. Complications within the first 30 days included urinary tract infections (1.7%), urinary retention (3.6%), and delayed bleeding (7.1%). These complications were managed conservatively. At 12-month follow-up, median QoL [5 (IQR 3.75-5) vs. 1 (IQR 1-2)], IPSS [21.5 (IQR 15.5-23.75) vs. 5 (IQR 3-8)], Qmax [7.7 (IQR 6.3-10) vs. 28.3 (IQR 21.25-39.2) ml/s], and postvoiding residual urine [100 (IQR 46-200) vs. 17.5 (IQR 0-36) ml] improved significantly (p < 0.002).

Conclusions: Thulium VapoEnucleation of the prostate seems to be a safe and efficacious procedure for the treatment of symptomatic BPO in patients at high cardiopulmonary risk on OA.

Citing Articles

Anatomic endoscopic enucleation of the prostate using a novel hybrid thulium:yttrium-aluminium-garnet laser generator: surgical technique and clinical outcomes.

Ventimiglia E, Orecchia L, Bevilacqua L, Tondelli E, Oliva I, Cindolo L World J Urol. 2024; 42(1):498.

PMID: 39214884 DOI: 10.1007/s00345-024-05207-7.

Reasons to go for thulium-based anatomical endoscopic enucleation of the prostate.

Becker B, Netsch C, Bozzini G, Herrmann T, Bach T, Enikeev D World J Urol. 2021; 39(7):2363-2374.

PMID: 33948694 DOI: 10.1007/s00345-021-03704-7.

Recent evidence for anatomic endoscopic enucleation of the prostate (AEEP) in patients with benign prostatic obstruction on antiplatelet or anticoagulant therapy.

Netsch C, Herrmann T, Bozzini G, Berti L, Gross A, Becker B World J Urol. 2021; 39(9):3187-3196.

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Nomenclature in thulium laser treatment of benign prostatic hyperplasia: it's time to pull the rabbit out of the hat.

Maruccia S, Fulgheri I, Montanari E, Casellato S, Boeri L Lasers Med Sci. 2021; 36(7):1355-1367.

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Lasers in Transurethral Enucleation of the Prostate-Do We Really Need Them.

Herrmann T, Gravas S, de la Rosette J, Wolters M, Anastasiadis A, Giannakis I J Clin Med. 2020; 9(5).

PMID: 32397634 PMC: 7290840. DOI: 10.3390/jcm9051412.

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