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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

Can the lower urinary tract storage symptoms be completely resolved after plasmakinetic enucleation of the prostate？

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Asian Journal of Andrology 2017年第6期19卷 655-658页

作者： Bing-Kun Li Bin-Shen Chen Yu-Hong Xin Chun-Xiao Liu Shao-Bo Zheng Ya-Wen Xu Hu-Lin Li Yong Zou Li-Ping Li Department of Urology Zhujiang Hospital Southern Medical University Guangzhou 510282 China Department of Urology The People's Hospital of Jiangmen Jiangmen 529020 China Department of Urology Zhongshan Hospital Fudan University Shanghai 200032 China.

The aim of this study was to determine whether the lower urinary tract storage symptoms of benign prostatic obstruction （BPO） could be completely resolved after plasmakinetic enucleation of the prostate （PKEP） and the possible predictors of persistent symptoms. Two hundred and sixty-seven cases of BPO performed PKEP from July 2008 to June 2009 were retrospectively analyzed. Five-year postoperative data were collected and compared with the preoperative data. According to the urodynamic results, the patients were divided into involuntary detrusor contraction （IDC） group （n = 95） and no IDC group （n = 172） preoperatively; the patients with IDC were divided into IDC-persistent group （n = 33） and IDC-resolved group （n = 62） after PKER The predictors of persistent IDC were analyzed. Compared with the preoperative data, the 5-year postoperative data showed that the IDC rate was lower （P --- 0.000）, Overactive Bladder Symptom Score （OABSS） was lower （P = 0.000）, maximum cystometric capacity （MCC） was larger （P= 0.000）, Prostate volume （PV） was smaller （P= 0.000）, and prostate-specific antigen （PSA） was lower （P= 0.000）. Compared with the no IDC group, the IDC group showed that the age was older （P = 0.016）, MCC was smaller （P = 0.004）, PSA was higher （P = 0.016）, and Chronic Inflammation rate was higher （P = 0.004）. Compared with IDC-resolved group after PKER IDC-persistent group showed that the age was older （P = 0.019）, MCC was smaller （P = 0.000）, PSA was higher （P = 0.013）, and Chronic Ihflammation rate was higher （P = 0.032）. The present study shows that the storage symptoms are still needed to be focused on after PKER The advanced patient age, MCC, PSA, and chronic inflammation may be the important clinical predictors of persistent IDC.

关键词： age factors benign prostatic obstruction lower urinary tract storage symptoms plasmakinetic enucleation of the prostate urodynamic parameter

Management of BPH then 2000 and now 2016-From BPH to BPO

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Asian Journal of Urology 2017年第3期4卷 138-147页

作者： Johan Braeckman Louis Denis Department of Urology UZ BrusselBrusselsBelgium Oncology Center Antwerp(OCA) AntwerpBelgium

The diagnosis and treatment of benign prostatic obstruction(BPO)is based on a number of well-known lower urinary tract symptoms(LUTS)feared by all ageing males with functional *** ascent of modern urology turned this disease from lethal into an annoying but treatable health problem in the previous *** are able to relieve the great majority of patients from their bothersome symptoms to a respectable quality of life by medication or removal of the obstructive part of the enlarged *** can be proud of some progress made in the new millennium to reach a correct diagnosis and subsequent choice of treatment aiming for quality of life and cost-efficiency for public *** it remains symptomatic treatment and we expect the new generation of urologists to close some gaps in our knowledge on the regulation of prostatic growth to focus on prevention and elimination of the disease in the foreseeable future.

关键词： benign prostate hyperplasia benign prostatic obstruction Lower urinary tract symptoms Pharmacological treatment Transurethral resection of the prostate Laser prostatectomy Minimal invasive treatment

Multicenter experience with photoselective vaporization of the prostate on men taking novel oral anticoagulants

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Asian Journal of Urology 2020年第4期7卷 340-344页

作者： Brooke Sachs Vincent Misrai Shahin Tabatabaei Henry H.Woo Bankstown-Lidcombe Hospital SydneyAustralia Clinique Pasteur ToulouseFrance Massacheussets General Hospital BostonUSA The Chris O’Brien Lifehouse Hospital SydneyAustralia

Objective:Photoselective vaporization of the prostate(PVP)is a widely performed surgical procedure for benign prostatic *** approach has become particular favoured for men on anti-platelet and anticoagulation agents such as clopidogrel and warfarin but there is minimal published experience in the setting of novel oral anticoagulants(NOACs).This study was to examine the perioperative outcomes in men on NOACs undergoing PVP,with particular reference to perioperative ***:A retrospective analysis of PVP datasets was undertaken from three centres in Sydney(Australia),Toulouse(France)and Boston(USA).Subjects who had been treated whilst on NOACs without discontinuation or bridging were *** outcomes and treatment parameters were examined and morbidity recorded according to Clavien-Dindo(CD)***:There were a total of 20 subjects who had undergone PVP whilst NOACs had been continued during the perioperative *** mean age was 776.5 *** mean prostate volume,energy utilization and vaporisation time was 9456 mL,301211 kJ,and 3521 min *** mean postoperative duration of catheterization and duration of hospitalization was 2.22.4 days and 2.42.4 days *** was a single episode of urinary tract infection and four subjects required re-catheterisation for non-hematuric ***:This study supports the safety of men on NOACs undergoing *** this study represents the largest experience of PVP in these men,larger studies are necessary to confirm the safety of PVP in this group of men undergoing BPH-related surgery.

关键词： benign prostatic hyperplasia benign prostatic obstruction Photoselective vaporisation of the prostate Non-vitamin K oral anticoagulants Novel oral anticoagulants

Beyond prostate, beyond surgery and beyond urology: The “3Bs” of managing non-neurogenic male lower urinary tract symptoms

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Asian Journal of Urology 2019年第2期6卷 169-173页

作者： Qixiang Song Paul Abrams Yinghao Sun Department of Urology Changhai HospitalSecond Military Medical UniversityShanghaiChina Bristol Urological Institute Southmead HospitalBristolUK

Lower urinary tract symptoms(LUTS),consisting storage,voiding and postmicturition symptoms,is a comprehensive definition involving symptoms that may occur due to several *** of simply focusing on the enlarged prostate,more attention has to be paid to the entire urinary tract as well as multiple system ***,prostate surgery alone does not necessarily provide adequate management and cross-disciplinary collaborations are sometimes *** on current literature,this paper proposes the“3Bs”concept for managing non-neurogenic male LUTS,namely,“beyond prostate”,“beyond surgery”and“beyond urology”.The clinical application of the“3Bs”enables urologists to carry out integrated,individualized and precise medical care for each non-neurogenic male LUTS patient.

关键词： Male Lower urinary tract symptoms benign prostatic hyperplasia benign prostatic obstruction Detrusor overactivity Detrusor underactivity Prostate surgery Comorbidities