Thulium Laser Prostate Enucleation in Refractory Urinary Retention: Operative and Functional Outcomes in a Large Cohort of Patients

Urology. 2016 Jul:93:152-7. doi: 10.1016/j.urology.2016.02.015. Epub 2016 Mar 23.

Abstract

Objective: To evaluate the functional and operative results of thulium laser enucleation of the prostate (ThuLEP) in patients with indwelling catheters for refractory urinary retention.

Methods: Patients with indwelling catheter, undergoing ThuLEP for benign prostate hyperplasia, were prospectively enrolled. Every episode of urinary retention was treated with urinary catheter positioning followed by at least 2 attempts of catheter removal. Patients were investigated with flowmetry and the self-administered International Prostate Symptom Score questionnaire at 30 and 90 days following ThuLEP.

Results: Three hundred eighty-one patients underwent ThuLEP, and 99 of these had indwelling catheters, but only 93 (24%) were eligible according to the inclusion criteria. In 46 patients the bladder catheter was removed on the first postoperative day, in 31 patients on the second postoperative day, in 5 patients on the third postoperative day, in 6 patients on the fourth postoperative day, in 1 patient on the fifth postoperative day, and in 2 patients each on the sixth and seventh postoperative days. The average hospital stay was 2.3 (±1.7) days. No patients undergoing ThuLEP, at the 90-day follow-up, required further catheterization. Flowmetry showed significant improvement in all parameters, and the mean International Prostate Symptom Score dropped from 21.33 preoperatively to 3.2 (P = .004) at 90 days postoperatively.

Conclusion: This prospective study shows that ThuLEP is a safe and effective approach in refractory urinary retention patients. In our case series, no patients required postoperative intermittent catheterization. All functional outcomes investigated reported a statistical significant improvement.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Humans
  • Laser Therapy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Prostatectomy / methods*
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / surgery*
  • Recovery of Function
  • Thulium / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Urinary Retention / etiology*
  • Urinary Retention / surgery*

Substances

  • Thulium