Login to Access Video or Poster Abstract: MP02-15
Sources of Funding: None.

Introduction

To assess the long-term results of thulium vapoenucleation of the prostate (ThuVEP) for the treatment of symptomatic benign prostatic obstruction (BPO) retrospectively.

Methods

500 patients with symptomatic BPO were treated with ThuVEP and consecutive mechanical morcellation between January 2007 and January 2010 at our institution. Patients were reassessed 1 and 5 years after ThuVEP with International Prostate Symptom Score (IPSS), Quality of Life (QoL), maximum urinary flow rate (Qmax), post-void residual urine (PVR), PSA, and prostate volume measured by transrectal ultrasound. To assess treatment effects, patients were divided into two groups according to the prostate volume: group A (<60ml) and group B (>60ml). Patient data is presented as median (interquartile range).

Results

131 patients completed the 5-year follow-up and were included in the final analysis. IPSS, QoL, Qmax, and PVR improved significantly and continued to do so during 5-year follow-up (p≤0.001). At 1-year follow-up, the median prostate volume (50 ml vs. 13 ml, p<0.001) decreased significantly with a median prostate volume reduction of 80.8% (64.3-88%). Median PSA was significantly reduced at 1-year (0.83 μl/l) and 5-year (0.72 μg/l) follow-up as compared to median preoperative PSA (3.39 μg/l) (p≤0.001). The median PSA-reduction was 77.1% (51.5-89.3%) at 5-year follow-up and significantly different between group A (70.2% (42.7-87.3)%) and group B (83.5% (70.2-91.5%)) (p≤0.006). IPSS was significantly lower at 5-year follow-up in group B compared to group A (2.5 vs. 6, p<0.001), while Qmax, QoL, PVR showed no differences at 5-year follow-up between the groups. Bladder-neck contractures (n=4) and urethral strictures (n=4) developed 3.1% of the patients each. Three patients (2.3%) were re-treated during follow-up for recurrent prostatic tissue.

Conclusions

ThuVEP is a durable procedure for the treatment of symptomatic BPO with regard to micturition improvement and prostate volume reduction. The reintervention rate of the ThuVEP procedure at long-term follow-up was low.

Funding

None.