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. 2015 Nov;56(11):769-74.
doi: 10.4111/kju.2015.56.11.769. Epub 2015 Nov 3.

A novel one lobe technique of thulium laser enucleation of the prostate: 'All-in-One' technique

Yeon Joo Kim  1 , Yoon Hyung Lee  1 , Joon Beom Kwon  1 , Sung Ryong Cho  1 , Jae Soo Kim  1
Affiliations

A novel one lobe technique of thulium laser enucleation of the prostate: 'All-in-One' technique

Yeon Joo Kim et al. Korean J Urol. 2015 Nov.

Abstract

Purpose: The thulium laser is the most recently introduced technology for the surgical treatment of benign prostatic hyperplasia (BPH). Until recently, most thulium laser enucleation of the prostate (ThuLEP) was performed by use of the three-lobe technique. We introduce a novel one-lobe enucleation technique for ThuLEP called the "All-in-One" technique. We report our initial experiences here.

Materials and methods: From June 2013 to May 2014, a total of 47 patients underwent the All-in-One technique of ThuLEP for symptomatic BPH performed by a single surgeon. All patients were assessed with the International Prostate Symptom Score (IPSS), transrectal ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR) before and 1 month after surgery. We reassessed IPSS, Qmax, and PVR 3 months after surgery. To assess the efficacy of the All-in-One technique, we checked the PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate.

Results: The mean operative time was 82.1±33.3 minutes. The mean enucleation time and morcellation time were 52.7±21.7 minutes and 8.2±7.0 minutes, respectively. The mean resected tissue weight and decrease in hemoglobin were 36.9±24.6 g and 0.4±0.8 g/dL, respectively. All perioperative parameters showed significant improvement (p<0.05). No major complications were observed. The PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate were 0.81, 0.92, and 4.3%, respectively.

Conclusions: The All-in-One technique of ThuLEP showed efficacy and effectiveness comparable to that of other techniques. We expect that this new technique could reduce the operation time and the bleeding and improve the effectiveness of enucleation.

Keywords: Laser therapy; Prostatic hyperplasia; Thulium.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Overview of 'All-in-One' technique. (A) Making an inverted-U shaped incision line. (B) Marking incision at 12 o'clock area of apex. (C) Connecting the incision line circumferentially. (D) Enucleation. Scan this QR code to see the accompanying video, or visit www.kjurology.org or https://youtu.be/ShJ6GLAR2MY.
See this image and copyright information in PMC

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