Email this article Thulium laser enucleation of the prostate in patients with large benign prostate hyperplasia and acute urinary retention
- Authors: Kostenkov N.Y.1,2, Al-Shukri S.K.1, Nevirovich E.S.1,2, Mosiychuk O.M.2, Kuzmin I.V.1, Tkachuk I.N.1,2
-
Affiliations:
- Academician I.P. Pavlov First St. Petersburg State Medical University
- City Hospital No. 15
- Issue: Vol 13, No 2 (2023)
- Pages: 109-115
- Section: Original articles
- URL: https://bakhtiniada.ru/uroved/article/view/134250
- DOI: https://doi.org/10.17816/uroved501787
- ID: 134250
Cite item
Open Access
Access granted
Subscription Access
Abstract
BACKGROUND: Benign prostatic hyperplasia is the most common urological disease in older men, leading to the development of bladder outlet obstruction and a decrease in the quality of life of patients. The choice of the method of surgical treatment of benign prostatic hyperplasia with large prostate volumes is the subject of discussion. There is also no unified approach to the management of patients with acute urinary retention due to benign prostatic hyperplasia.
AIM: To evaluate the results of thulium laser enucleation of the prostate in patients with large benign prostatic hyperplasia associated with acute urinary retention.
MATERIALS AND METHODS: The present study included the results of treatment of 237 patients with benign prostatic hyperplasia with a prostate volume of more than 80 cm3, of which 97 were hospitalized in the urology department for acute urinary retention. The age of the patients ranged from 51 to 89 years (average 70.2 years). The volume of the prostate gland ranged from 80 to 150 cm3 (mean 128.3 cm3). The control examination was performed on the 2nd day, as well as 3, 6 and 12 months after the surgery.
RESULTS: Surgical intervention was performed using a thulium fiber laser device FiberLase U1 (IRE-Polyus, Russia) with a power of 120 W. The time of surgery ranged from 63 to 127 minutes (average 74.3 minutes). The irrigation system was turned off on the 1st day of the postoperative period. The duration of urethral catheterization averaged 2.7 days. None of the patients in the study required blood transfusion or repeated surgery to coagulate the vessels of the prostate bed. After removal of the urethral catheter, all patients urinated on the first attempt. In 7 patients (2.95%), after removal of the urethral catheter, urinary incontinence was observed, during the first 6 months after the operation, urinary retention was restored in all of them. We did not note significant differences during the intra-, early and late postoperative period in operated BPH patients with and without acute urinary retention.
CONCLUSIONS: ThuLEP is an effective and safe method of surgical treatment of patients with benign prostatic hyperplasia with a prostate volume of more than 80 cm3, complicated by acute urinary retention.
Full Text
##article.viewOnOriginalSite##About the authors
Nikolay Yu. Kostenkov
Academician I.P. Pavlov First St. Petersburg State Medical University; City Hospital No. 15
Author for correspondence.
Email: drkostenkov@rambler.ru
ORCID iD: 0000-0001-8246-8798
SPIN-code: 5455-1516
postgraduate student, urologist, urological unit
Russian Federation, Saint Petersburg; Saint PetersburgSalman Kh. Al-Shukri
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: alshukri@mail.ru
ORCID iD: 0000-0002-4857-0542
SPIN-code: 2041-8837
Scopus Author ID: 6506423220
MD, Dr. Sci. (Med.), professor, head of the Department of Urology
Russian Federation, Saint PetersburgEvgeniy S. Nevirovich
Academician I.P. Pavlov First St. Petersburg State Medical University; City Hospital No. 15
Email: enevirovich@gmail.com
ORCID iD: 0000-0001-8427-5092
SPIN-code: 9362-4145
MD, Cand. Sci. (Med.), assistant professor, head of the urological unit
Russian Federation, Saint Petersburg; Saint PetersburgOleg M. Mosiychuk
City Hospital No. 15
Email: oleg.mosichuk@yandex.ru
ORCID iD: 0009-0003-7979-1086
deputy chief physician for medical affairs
Russian Federation, Saint PetersburgIgor V. Kuzmin
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: kuzminigor@mail.ru
ORCID iD: 0000-0002-7724-7832
SPIN-code: 2684-4070
Scopus Author ID: 56878681300
Dr. Sci. (Med.), professor of the Department of Urology
Russian Federation, Saint PetersburgIlia N. Tkachuk
Academician I.P. Pavlov First St. Petersburg State Medical University; City Hospital No. 15
Email: tkachuk2@yandex.ru
Cand. Sci. (Med.), assistant professor of the Department of Urology, urologist, Urological Unit
Russian Federation, Saint Petersburg; Saint PetersburgReferences
- Dobrokachestvennaya giperplaziya predstatel’noi zhelezy. Klinicheskie rekomendatsii Minzdrava RF. 2020 Available from: https://cr.minzdrav.gov.ru/recomend/6._ (In Russ.)
- Gondran-Tellier B, McManus R, Sichez PC, et al. Efficacy and safety of surgery for benign prostatic obstruction in patients with preoperative urinary catheter. J Endourol. 2021;35(1):102–108. doi: 10.1089/end.2020.0704
- Shormanov IS, Kulikov SV, Solovyov AS. Features of compensatory and adaptive reactions of the vascular bed of the bladder of elderly and senile men with prostatic hyperplasia. Uro logy reports (St. Petersburg). 2022;12(2):127–135. (In Russ.) doi: 10.17816/uroved108475
- Huang LK, Chang YH, Shao IH, et al. Clinical outcome of immediate transurethral surgery for benign prostate obstruction patients with acute urinary retention: more radical resection resulted in better voiding function. J Clin Med. 2019;8(9):1278. doi: 10.3390/jcm8091278
- McNeill SA, Hargreave TB; Members of the Alfaur Study Group. Alfuzosin once daily facilitates return to voiding in patients in acute urinary retention. J Urol. 2004;171(6 Pt 1):2316–2320. doi: 10.1097/01.ju.0000127743.80759.7a
- Mavrotas J, Gandhi A, Kalogianni V, et al. Acute urinary retention. Br J Hosp Med (Lond). 2022;83(1):1–8. doi: 10.12968/hmed.2021.0278
- Kostenkov NY, Al-Shukri SK, Amdiy RE, et al. Thulium laser enucleation of prostate (ThuLEP): efficacy and safety evaluation in patients with a prostate volume more than 80 cm3. Uro logy reports (St. Petersburg). 2022;12(3):211–220. (In Russ.) doi: 10.17816/uroved110730
- Kostenkov NYu, Nevirovich ES, Gorelik SG, et al. Comparative assessment of the intra- and early postoperative period in patients of elderly and old age after various methods of surgical treatment of large benign prostatic hyperplasia. Consilium Medicum. 2022;24(7):447–450. (In Russ.) doi: 10.26442/20751753.2022.7.201876
- Bozzini G, Berti L, Maltagliati M, et al. Current evidence of ThuLEP for BPH: A review of literature. Turk J Urol. 2021;47(6): 461–469. doi: 10.5152/tud.2021.21170
Supplementary files
