Department of Urology, Faculty of Medicine, University of Freiburg - Medical Centre, Hugstetter Str. 55, 79106, Freiburg, Germany.
Department of Urology, Istanbul University Istanbul School of Medicine, Istanbul, Turkey.
World J Urol. 2024 Aug 2;42(1):467. doi: 10.1007/s00345-024-05141-8.
The solid-state Thulium laser (Tm: YAG) is a novel alternative to the widely used Holmium laser for endoscopic enucleation of the prostate (EEP) due to its relatively high peak power. The aim of this study was to examine the efficacy and safety of a new pulsed Tm: YAG laser in its first application in humans.
Data were retrospectively collected for the first 103 patients who underwent EEP with a new pulsed solid-state Tm: YAG laser (Thulio, Dornier MedTech Systems GmbH, Weßling, Germany). Peri- and postoperative data were assessed. Procedure-specific complications were graded using Clavien-Dindo Classifications (CDC). Patients were interviewed 15 months after the surgery to evaluate functional and long-term outcomes. Statistical analysis was performed with Statistical Package for the Social Sciences (SPSS).
The mean preoperative prostate volume was 105.6 ± 55.0 ml. Median enucleation speed was 4.1 g per minute (range 1.1-9.7). Short-term postoperative complications occurred in 21 patients (20.4%), but no high-grade complications (CDC ≥ IV) were observed. Five patients suffered gross haematuria and required reintervention (CDC IIIb; 4.9%). After 15 months, 76 patients (73.8%) participated in the follow-up interview, where seven patients (9.2%) reported complications, including two reinterventions for urethral strictures (CDC IIIb; 2.6%). Most patients reported an improvement in continence (54.0%) and urine stream (93.4%), but no difference in erectile function (81.6%). No persistent dysuria was reported. Patient satisfaction with the surgery results was very high (96.1%).
Endoscopic enucleation of the prostate with the new pulsed solid-state Tm: YAG laser is a safe and effective option for surgical BPH treatment.
German Clinical Trials Register number: DRKS00031676. Registration date: 10 May 2023, retrospectively registered.
由于其相对较高的峰值功率，固态钬激光（Tm：YAG）是一种替代广泛应用于前列腺内镜切除术（EEP）的新型激光。本研究旨在研究新型脉冲固态 Tm：YAG 激光在人体首次应用中的疗效和安全性。
回顾性收集了 103 名接受新型脉冲固态 Tm：YAG 激光（Thulio，多尼尔医疗技术系统有限责任公司，韦斯林，德国）行 EEP 的患者的数据。评估围手术期和术后数据。使用 Clavien-Dindo 分类（CDC）对特定手术并发症进行分级。术后 15 个月对患者进行访谈，以评估其功能和长期结果。使用社会科学统计软件包（SPSS）进行统计分析。
平均术前前列腺体积为 105.6±55.0ml。中位剜除速度为 4.1g/分钟（范围 1.1-9.7）。21 例患者（20.4%）出现短期术后并发症，但无高等级并发症（CDC≥IV）。5 例患者出现肉眼血尿，需要再次干预（CDC IIIb；4.9%）。术后 15 个月，76 例患者（73.8%）参与了随访访谈，其中 7 例患者（9.2%）报告了并发症，包括 2 例尿道狭窄再次干预（CDC IIIb；2.6%）。大多数患者报告尿失禁（54.0%）和尿流（93.4%）得到改善，但勃起功能无差异（81.6%）。无持续排尿困难报告。患者对手术结果的满意度非常高（96.1%）。
新型脉冲固态 Tm：YAG 激光的前列腺内镜剜除术是治疗 BPH 的一种安全有效的选择。
德国临床试验注册中心编号：DRKS00031676。注册日期：2023 年 5 月 10 日，回顾性注册。
