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  • Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.

Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.

Urology (2014-12-23)
Steffen Rausch, Thomas Heider, Jens Bedke, Stephan Kruck, Christian Schwentner, Karsten Fischer, Arnulf Stenzl, Tilman Kälble
ABSTRACT

To evaluate complications and functional outcome and to identify patient-associated risk factors, we analyzed consecutive patients undergoing thulium:yttrium-aluminum-garnet laser enucleation of the prostate (ThuLEP) in our department. A total of 234 patients were prospectively analyzed. Preoperative data, postoperative complications, and outcome at 6, 12, and 24 months were recorded. Individual risk factors for complications and treatment failure were assessed by univariate and multivariate analyses. Mean age at surgery was 72.88 ± 7.83 years. Mean preoperative prostate size was 84.8 ± 34.9 mL. Thirty-day complication rate was 19.7%. Functional treatment failure occurred in 9.0% of all patients. Decline of mean International Prostate Symptom Score was -75%, quality of life index -76%, and postvoid residual -86% at 24 months. Maximum urine flow at 24 months was improved at +231%. In univariate analysis, age >80 years and prostate size <50 mL were significant predictors of complications, which was confirmed by multivariate analysis (P = .0277 and .0409, respectively). Age >80 years, prostate size <80 mL or <50 mL, and American Society of Anesthesiologists classification were significant predictors of functional treatment failure in univariate analysis. Prostate size <80 mL or <50 mL was significantly associated with treatment failure (P < .001) in multivariate analysis. ThuLEP is a safe and efficient surgical procedure, even in a patient cohort with high prostate volumes, age, and comorbidities. However, high patient age and small prostate size were significant determinants of adverse outcomes after surgery. To address the question of optimal therapy selection for patients with prostates smaller than 80 mL, further prospective randomized evaluation of ThuLEP and alternative surgical interventions is needed.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Aluminum, ACS reagent, 99%, wire, wire diam. ~1.5 mm
Sigma-Aldrich
Aluminum, ReagentPlus®, beads, 5-15 mm, 99.9% trace metals basis
Aluminum, honeycomb, 600x600mm, thickness 20mm, cell size 3.2mm, cell wall 0.025mm, core density 0.072g/cm3, phenolic adhesive (resin), 99.5%
Aluminum, honeycomb, 300x300mm, thickness 10mm, cell size 6.3mm, cell wall 0.064mm, core density 0.083g/cm3, phenolic adhesive (resin), 99.5%
Yttrium, wire reel, 0.1m, diameter 0.5mm, 99.9%
Yttrium, wire reel, 0.05m, diameter 0.5mm, 99.9%
Aluminum, foam, 150x150mm, thickness 30mm, bulk density 0.2g/cm3, porosity 0.93, aluminum 6101 grade, 98.5%
Aluminum, honeycomb, 300x300mm, thickness 13.9mm, cell size 6.3mm, cell wall 0.064mm, core density 0.083g/cm3, phenolic adhesive (resin), facing skin aluminum 0.55mm, 99.9%
Aluminum, honeycomb, 300x300mm, thickness 52.3mm, cell size 6.3mm, cell wall 0.064mm, core density 0.083g/cm3, phenolic adhesive (resin), facing skin glass fiber 0.75mm, 99.9%
Aluminum, honeycomb, 300x300mm, thickness 5mm, cell size 19mm, cell wall 0.064mm, core density 0.029g/cm3, phenolic adhesive (resin), 99.5%
Aluminum, honeycomb, 600x600mm, thickness 52.3mm, cell size 6.3mm, cell wall 0.064mm, core density 0.083g/cm3, phenolic adhesive (resin), facing skin glass fiber 0.75mm, 99.9%
Aluminum, honeycomb, 300x300mm, thickness 26.5mm, cell size 6.3mm, cell wall 0.064mm, core density 0.083g/cm3, phenolic adhesive (resin), facing skin carbon fiber / epoxy, 99.9%
Aluminum, honeycomb, 300x300mm, thickness 20mm, cell size 4.8mm, cell wall 0.038mm, core density 0.070g/cm3, phenolic adhesive (resin), 99.5%
Aluminum, honeycomb, 600x600mm, thickness 10mm, cell size 6.3mm, cell wall 0.064mm, core density 0.083g/cm3, phenolic adhesive (resin), 99.5%
Aluminum, honeycomb, 600x600mm, thickness 5mm, cell size 3.2mm, cell wall 0.025mm, core density 0.072g/cm3, phenolic adhesive (resin), 99.5%
Yttrium, wire reel, 0.1m, diameter 1.0mm, 99.9%
Aluminum, honeycomb, 600x600mm, thickness 5mm, cell size 13mm, cell wall 0.1mm, core density 0.062g/cm3, phenolic adhesive (resin), 99.5%
Aluminum, honeycomb, 300x300mm, thickness 26.5mm, cell size 6.3mm, cell wall 0.064mm, core density 0.083g/cm3, phenolic adhesive (resin), facing skin aluminum 0.55mm, 99.9%
Sigma-Aldrich
Yttrium sputtering target, diam. × thickness 2.00 in. × 0.25 in., 99.9% trace metals basis
Thulium, foil, not light tested, 25x25mm, thickness 0.025mm, as rolled, 99%
Thulium, foil, 25x25mm, thickness 0.1mm, as rolled, 99%
Thulium, foil, not light tested, 25x25mm, thickness 0.005mm, as rolled, 99%
Thulium, foil, 50x50mm, thickness 0.1mm, as rolled, 99%
Aluminum, wire reel, 100m, diameter 0.25mm, hard, 99.99+%
Aluminum, rod, 200mm, diameter 12.0mm, as drawn, 99.999%
Aluminum, wire reel, 100m, diameter 0.25mm, as drawn, 99.5%
Aluminum, wire reel, 0.5m, diameter 0.5mm, as drawn, 99.999%
Aluminum, sphere, 100pcs, diameter 3.0mm, aluminum alloy 2017 precision sphere, grade 200, 95.2%
Aluminum, wire reel, 1000m, diameter 0.7mm, as drawn, 99.5%
Aluminum, wire reel, 0.5m, diameter 1.0mm, as drawn, 99.999%