Tm:YAG laser vapoenucleation (ThuVEP) – One-year follow-up in elderly patients

Purpose

Thulium:YAG (Tm:YAG) laser vapoenucleation (ThuVEP) has been introduced in the treatment of benign prostatic obstruction (BPO) with promising results. However, with an aging population in the industrialized nations and improved medical therapy, the patients seeking treatment for BPO are getting older. Surgical therapy in this group of patients may not only be less effective due to the overall constitution of the patient but also due to the prolonged time of suffering from BPO. The aim of this study was to evaluate intermediate-term efficacy of ThuVEP in older patients. The outcome and complications of patients were analyzed after a postoperative follow-up period of 12 months and the results of subgroups aged both above and below 75 years were compared.

Material and methods

Laser prostatectomy was performed using a 70 W Tm:YAG 2 μm continuous wave laser (LISA laser, Katlenburg, Germany) in combination with a continuous-flow laser resectoscope and a mechanical tissue morcellator (R. Wolf, Knittlingen, Germany). The condition of patients was followed in terms of improvement of uroflow and post-void residual urine, intra- and postoperative course and the occurrence of complications.

Results

Eighty consecutive patients were included in this prospective observation. Patients were grouped according to age. Subgroup I included patients with an age ≥75 years, subgroup II included patients <75 years. The mean age was 80.2 years in subgroup I and 66.6 years in subgroup II. Preoperative data was comparable in both groups, as well as improvements in postoperative voiding function.

Conclusion

Transurethral ThuVEP is a safe and effective therapy method even in older patients. The patient's age does not influence the functional operative outcome.