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Efficacy and Safety of High energy ThuVAP (Thulium laser Vaporization of Prostatic Adenoma) at 200W

Serena Maruccia, Alessandra Cassani, Robert Stubinski, Matteo Follini, Salvatore Micali, Giorgio Bozzini, Federica Mazzoleni, Maria Chiara Sighinolfi, Bernardo Rocco

Abstract

Objectives: BPH is a common condition afflicting the aging male. The aim of our study is to highlight the safety and efficacy of high power (200 Watt) ThuVAP as a valid alternative treatment option for BPH unresponsive to medical therapy and associated with LUTS.

Methods: Patients with BPH unresponsive to conventional therapy were treated with ThuVAP at high power - 200Watts (between July 2020 - December 2021). 106 patients were enrolled and 98 underwent surgery. ThuVAP was performed with a standard Iglesias 26ch resectoscope employing a 800μm fiber with a continuous mode 200Watt setting for vaporization and a 30Watt setting for hemostasis on a Quanta system Cyber TM thulium laser. Patients were evaluated pre- and post operatively by an senior consultant urologists.

Results: A total of 98 patients were treated. Patient preoperative characteristics were: mean IPSS of 26, mean QOL of 5, preop Qmax 5.7±4.3ml/sec, PVR 173±35 ml, prostate size (as measure on transrectal ultrasound) 133±65 ml, prostate adenoma size 94±40 ml, mean PSA 4.14 ng/ml. Post operative characteristics were evaluated at 45 days after surgery and evidenced mean IPSS of 12, QOL 1.3, Qmax 19.7±3.2ml/sec, PVR 21±5ml, PSA 1.1ng/ml. All patients referred improvement regarding symptoms and QOL with ameliorated perception of voiding as confirmed by uroflowmetry values. No adverse events were recorded.

Conclusions: Our study showed that 200watt ThuVAP is a safe, repeatable, and effective treatment modality in patients with symptomatic BPH unresponsive to conventional therapy.

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