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Thulium：YAG VapoEnucleation of the prostate in large glands： a prospective comparison using 70- and 120-W 2-μm lasers

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Asian Journal of Andrology 2012年第2期14卷 325-329页

作者： christopher netsch Thorsten Bach Thomas RW Herrmann Andreas J Gross Department of Urology Asklepios Hospital BarmbekHamburg 22291Germany Department of Urology MHH Medical School of HannoverHannover 30625Germany

This study compared the efficacy of 70- and 120-w 2-μm thulium：YAG VapoEnucleation of the prostate （ThuVEP） for patients with benign prostatic obstruction （BPO）. A prospective analysis of 84 patients with symptomatic BPO and prostatic enlargement （t〉 60 ml） who underwent either 70-w （n=44） or 120-w ThuVEP （n=40） non-randomly was carried out. Patient demographics and perioperative and 12-month follow-up data were analysed. The mean prostate volume was 79.90---27.49 ml in patients who had received 70-w ThuVEP, which was less than in those who had received 120-w ThuVEP （88.53＋-25.10; P=0.033）. The mean enucleation （resected weight/laser time, 2.16±1.21 g min-1 vs. 1.23±0.60 g min-1; P=-0.013）, operation efficiency （resected weight/total operation time, 0.76±0.35 g min-1 vs. 0.42＋-0.27 g min-1; P=-0.000） and percentage of resected tissue （66.93%±22.79% vs. 45.41%±23.33%; P=-0.000） were higher with 120-w treatment compared to 70-w ThuVEP. One patient （1.2% of total patients）（in the 120-w group） required a blood transfusion postoperatively. Sixty-one patients （73%） were available for review at the 12-month follow-up time point. The quality of life （QoL）, International Prostate Symptom Score （IPSS）, maximum urinary flow rate （Qmax）, postvoiding residual urine （PVR） and prostate volume improved significantly after treatment （P≤ 0.035） and were not significantly different between those treated with the different devices （70- and 120-w）. The median prostate volume reduction was 81.70% and 82.19% with 70- and 120-w ThuVEP, respectively. The incidence of complications was low and did not differ between groups treated with the different devices. Two patients （2.4%）（one per group） had a bladder neck contracture at the follow-up. ThuVEP is a safe and efficacious procedure for the treatment of symptomatic BPO. The incidence of complications was low with both devices. The 120-w thulium：YAG device enhances the effectiveness of Th,VEP with reeard to the oercentaee of resected tissue

关键词： benign prostatic obstruction laser prostate Revolix Tm:YAG ThuVEP VapoEnucleation

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Systematic evaluation of a holmium:yttrium-aluminum-garnet laser lithotripsy device with variable pulse peak power and pulse duration

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Asian Journal of Urology 2014年第1期1卷 60-65页

作者： christopher netsch Sophie Knipper Christian Tiburtius Andreas J.Gross Department of Urology Asklepios Hospital BarmbekHamburgGermany

Objective:The Holmium:yttrium-aluminum-garnet(Ho:YAG)laser is the standard lithotrite for *** paper is to evaluate a Ho:YAG laser with a novel effect function in vitro,which allows a real-time variation of pulse duration and pulse peak ***:Two types of phantom calculi with four degrees of hardness were made for fragmentation and retropulsion *** was analysed at 5(0.5 J/10 Hz),10(1 J/10 Hz),and 20(2 J/10 Hz)W in non-floating phantom calculi,retropulsion in an ureteral model at 10(1 J/10 Hz)and 20(2 J/10 Hz)W using floating phantom *** effect function was set to 25%,50%,75%,and 100%of the maximum possible effect function at each power *** outcomes:fragmentation(mm^3),the distance of retropulsion(cm);5 measurements for each ***:An increase of the effect feature(25%vs.100%),i.e.,an increase of pulse peak power and decrease of pulse duration,improved Ho:YAG laser *** effect was remarkable in soft stone composition,while there was a trend for improved fragmentation with an increase of the effect feature in hard stone *** increased with increasing effect function,independently of stone *** major limitations of the study are the use of artificial stones and the in vitro ***:Changes in pulse duration and pulse peak power may lead to improved stone fragmentation,most prominently in soft stones,but also lead to increased *** new effect function may enhance Ho:YAG laser fragmentation when maximum power output is limited or retropulsion is excluded.

关键词： Ureteroscopy Ho:YAG laser Lithotripsy Pulse peak power Pulse duration

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