Comparison of 120-200 W 2 μm thulium:yttrium-aluminum-garnet vapoenucleation of the prostate.

PURPOSE: To evaluate efficacy and safety of 200 W 2 μm thulium:yttrium-aluminum-garnet vapoenucleation of the prostate (ThuVEP) for patients with benign prostatic obstruction (BPO).

PATIENTS AND METHODS: Twenty-eight consecutive patients with symptomatic BPO were treated with 200 W ThuVEP. Patients were matched for age and preoperative prostate volume with 28 patients from our 120 W ThuVEP database. Patient data and postoperative outcome at 12-month follow-up were compared.

RESULTS: Mean prostate volume (65.39 vs 68.62 cc) and resected weight (40.72 vs 53.18 g) differed not significantly between 200 and 120 W ThuVEP. The percentage of resected tissue was lower with 200 W compared with 120 W (58.48 vs 72.93%, P=0.047) because of the higher rate of ablated tissue. There were no differences in mean operative (69.21 vs 78.67 min), laser (45.43 vs 48.58 min), morcellation (16.52 vs 20.48 min), and catheter (2.2 vs 2.1 d) time between the devices. Three patients needed immediate re-treatment (hemorrhage necessitating coagulation 1=200 W, secondary apical resection 2 120/200 W). One (1.79%) patient (120 W) needed a blood transfusion postoperatively. Fifty-one (91%) patients completed 12-month follow-up. Quality of life, International Prostate Symptom Score, peak urinary flow rate, postvoid residual urine, prostate-specific antigen level, and prostate volume improved significantly (P≤0.019) and were not different between the devices. At follow-up, two (3.57%) patients (120/200 W) had a bladder neck contracture.

CONCLUSIONS: ThuVEP is a safe and efficacious procedure for patients with symptomatic BPO. 120 and 200 W ThuVEP had an equivalent clinical outcome at 12-month follow-up.