2007 Jun;25(3):263-7 Three lobar enucleation technique was used when the median lobes were large. We have observed that the safety and high efficacy of ThuLEP was proven by various other studies. and transmitted securely. You may switch to Article in classic view. Thulium LASER is a safe and highly effective LASER in terms of blood loss, speed of tissue resection, drop in serum PSA, and versatility of prostatic resection. Transurethral laser operations of the prostate offer the advantage of decreased bleeding complications and the possibility to treat patients with bleeding disorders or anticoagulative treatment. Peng B, Chun G, Wang C. A comparative study of thulium laser resection of the prostate and bipolar transurethral plasmakinetic prostatectomy for treating benign prostatic hyperplasia. Following parameters were documented: Age, IPSS score, duration of surgery, retention, PSA, prostate size, Qmax, average flow rates, ASA score, associated co-morbidities, hypertension, IHD, DM, CRF, pacemakers, antiplatelet drugs, clot retention, readmission, postoperative symptoms of <1 month period, and late (>1 month) complications. ThuLEP (Thulium Laser Enucleation of Prostate) is the innovative transurethral thulium laser technique of anatomical enucleation. Vaporizes well vascularized or poorly vascularized tissue equally, providing effective hemostatis without creating deep coagulative necrosis seen with lower wavelength laser platforms. Transurethral removal of prostatic tissue is the treatment of choice for benign prostatic enlargement and benign prostatic obstruction. 2009 Nov;74(5):1105-10 The 2013 European Association of Urology (EAU) guidelines for the treatment and follow-up of non-neurogenic male lower urinary tract symptoms, including benign prostatic obstruction, formed the evidence base for the UNBLOCS study. Uretron Ultrasonic Lithotripter Urology, Lithotripter Storz Modulith SLX-F2 Urology. Humphreys MR, Miller NL, Handa SE, Terry C, Munch LC, Lingeman JE. The https:// ensures that you are connecting to the He works in GILROY, CA and 1 other location and specializes in General Surgery, Other Specialty and Urology. Leave all jewelry and valuables at home. If we compare the results of ThuLEP with few studies other of HoLEP, ThuLEP has many advantages as seen in the following studies [Table 3]. Feasibility of holmium laser enucleation of the prostate (HoLEP) for recurrent/residual benign prostatic hyperplasia (BPH). Laser energy of 70-90 W is only used for the incision at the verumontanum and bladder neck for removal of the middle lobe, whereas laser energy of 30 W was only used for coagulation of small vessel crossing the surgical capsule towards the transition zone and bladder neck for dissection of the lateral lobes. Those cardiac patients who are on ecosprin or aspirin need not to stop the anticoagulant after thulium Laser technology. Nr. Dr. Neil graduated from the Isfahan University of Medical Sciences in 1974. Inability to complete the operation endoscopically or with laser which requires conversion to TURP or an open incision or delayed morcellation on another day. Signs and symptoms of prostate problems include painful ejaculation, burning or pain while urinating, blood in the semen, and painful ejaculation. Conclusions: the display of certain parts of an article in other eReaders. Needing to pass urine frequently throughout the day. The muscles that maintain urine in place, the nerves that supply hardness, and the ejaculation are all better protected after surgery. You may have some discomfort when urinating for a couple of weeks. Who needs ThuLEP ( laser prostatectomy) and why ? Gujarat, India, Hirabhai Tower, Radhe Kishan Arista First Floor, Maninagar, Ahmedabad - 380008, Opposite Maninagar, 308, 3rd Floor Pushkar The durability of ThuVEP was demonstrated by a prostate-specific antigen (PSA)-reduction rate of 77.1% at 5-year follow-up [8]. We look forward to continuing to serve you. ThuLEPis performed under a general anaesthetic, through a endoscope introduced into your bladder through your urethra. The Cyber TM thulium laser provides an ideal blend of high efficiency and effective coagulation, making it the most accomplished prostate laser treatment modality. Prostate tissue left behind from prior procedures might develop over time, causing identical symptoms again.Because of the lower tissue penetration depth and steady operation of the wavelength with continuous energy at a certain temperature, the Thulium laser causes less tissue and cell damage. eCollection 2021 Jul. Bring a responsible adult companion to the hospital who will: remain in the hospital, be available to hospital personnel during your procedure, and assist you upon discharge by driving you home with close observation of your condition. 2015 Apr;33(4):525-30. doi: 10.1007/s00345-015-1529-0. (2) The inclusion criteria were maximum urinary flow rate (Qmax) <15 ml/s, International Prostate Symptoms Score (IPSS) >15 or acute retention of urine with the failure of catheter trial or Acute retention of urine with prior history of severe bladder outlet obstruction. With the ability to vaporize, resect or ablate in the treatment of BPH, the user can choose between surgical techniques best suited to the size and morphology of the treated prostate. Authors Experience with more than 1,000 holmium laser prostate enucleations for benign prostatic hyperplasia. Transurethral anatomical enucleation of the prostate with Tm:YAG support (ThuLEP): review of the literature on a novel surgical approach in the management of benign prostatic enlargement. Bhimajipura Cross The morsoscope or nephroscope used have limited vision due to small caliber of scopes and bladder being a large cavity. Team members deliver distinctive excellence, benefitting patients across the country. The advanced technology of MultiPulse Tm+1470 enables work with an excellent view of the operative field, thanks to the perfect hemostasis and the absence of residual material from carbonization. Transurethral removal of prostatic tissue is the treatment choice for benign prostatic enlargement and benign prostatic obstruction. (3) Hospital stay: 2436 h 218 patients (92.3%), 3648 h 18 patients (7.6%). HHS Vulnerability Disclosure, Help The effectiveness and safety of three surgical procedures for the treatment for benign prostatic hyperplasia: A network meta-analysis. Gross AJ, Netsch C, Knipper S, Hlzel J, Bach T. Complications and early postoperative outcome in 1080 patients after thulium vapoenucleation of the prostate: Results at a single institution. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Bopal-Ambli Junction With further research Italy made Latest and best high power (120 W) thulium laser technology for enlarged prostate. Wavelength: 2010 nm. Randomized prospective trial of the severity of irritative symptoms after HoLEP vs ThuFLEP. His prostate was estimated to be 153.4 gm on MRI. Failure of your urinary symptoms to improve. official website and that any information you provide is encrypted Worsening of storage symptoms (including frequency, urgency and nocturia) requiring further medication. (1) Two hundred and thirty-six patients with symptomatic BPH were treated with ThuLEP between March 2010 and September 2014 at our institute by a single surgeon. 2012 Dec;110(11 Pt C):E845-50. Preoperatively Qmax was in the range of 913.5 and it improved to 1824 in the postoperative period. The superiority of Thulium laser over other laser techniques in prostate surgery is due to its high cutting power, low tissue penetration (0.25mm) and constant temperature (continuous wavelength). Epub 2018 Aug 14. Its 2 m energy emission is primarily absorbed by water, ensuring the speed of vaporization is relatively constant. Avoid constipation and straining on the pelvic floor. Reduced urine flow. 6245 Hudson Crossing Parkway RevoLix is a multi-disciplinary surgical laser for the application in urology (surgical protocols for the treatment of BPH include vaporization (ThuVAP), vaporesection (ThuVARP), enucleation (ThuLEP) and vapoenucleation (ThuVEP) of prostate, gynaecology, neurosurgery*, ENT and pneumology. We present five distinct surgical steps for transurethral complete removal of the transition zone of the prostate (Thulium laser enucleation of the prostate, ThuLEP). Thus, a safer and more successful operation is performed. The consistent power delivery in continuous wave mode creates even and clean vaporization or cutting effect which keeps the surgical field clear of bubbles, blood or debris. 2010 Aug;106(3):368-72 On Call Surgical has many long-standing relationships with physicians, hospitals and surgery centers and believe that our partnership will enhance the value we bring to you as our customer. Smooth ball like prostatic tissue seen (cotton balls) at the end of morcellation is a greater problem as they need to be evacuated with forceps if small or removed by cutting with a laser. Gilroy California physician directory -The prostate is a gland that is part of the male reproductive system. Do not eat any solid food (including gum, hard candy or mints) after 12am (midnight) the night before surgery. Shao Q, Zhang FB, Shang DH, Tian Y. Transient reduction in erectile function (normally resolves if good sexual function prior to surgery). With Green Light Laser technology tissue is evaporated and ablated but biopsy can not be taken so one can easily miss out malignancy. We compared our data with preoperative data of 1080 patients who underwent thulium vaponucleation of the prostate stratified by prostate size [Table 5]. Would you like email updates of new search results? IPSS score was documented in 155 patients. BJU Int. Krambeck AE, Handa SE, Lingeman JE. ThuLEP method is the most effective method especially in the treatment of benign prostatic hyperplasia (BPH) or benign prostatic enlargement. Results Using the new thulium fiber laser, enucleation of the prostate can be successful performed. Six patients had not cleared urine totally without irrigation fluids (hematuria not stopped totally). Traction on Foley's catheter was not given in any patients except for two patients with significant hematuria in the immediate postoperative period. ThuLEP usually requires a one night stay in hospital. 2022 Jul;37(5):2517-2525. doi: 10.1007/s10103-022-03519-x. gentleman with a past medical history of hypertension. 1. The ASA grade III + were seen in 59 patients. All patients were followed for a period of minimum 11 months. At present in the market three laser technologies for enlarged prostate available in India. There was a gross difference in enucleation time and morcellation time in our study and this study. Still, compared to holmium laser transurethral enucleation of the prostate (HoLEP) the number of institutes all over the world using Thulium LASER are limited. The same procedure was repeated 9 oclock till 7 oclock. Urologists all over the world are in constant search for the gold standard treatment for benign prostatic hyperplasia (BPH). The drop in Hb in immediate postoperative period is also the least for ThuLEP in our group as compared to HOLEP, TURP, and PVP studies. Superior Tissue Effect: Thulium laser technology is highly beneficial to cardiac patients. Zhang F, Shao Q, Herrmann TR, Tian Y, Zhang Y. Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center. Enucleation: involves the detachment of the prostatic obstructive lobes using the endoscopic instrument while the laser beam ablates for quick hemostasis. Diseases & Conditions. The thulium laser is the most current and up-to-date laser technology for treating enlarged prostates (BPH). It is usually safe to drive 48-72 after the procedure. The catheter was removed within 24 h postoperative in 224 patients and within 48 h in 12 patients. Holmium laser is used during HoLEP surgery, and Thulium laser is used in ThuLEP surgery. Background: Methods In total, 110 patients suffering from . Safety and efficacy of dual emission endoscopic laser treatment in patients with upper or lower gastrointestinal vascular lesions causing chronic anemia: results from the first multicenter cohort study. All the associated events in intraoperative, immediate postoperative and till 6 weeks postoperative period was documented such as hematuria, clot retention, postoperative pain, urgency, frequency, dysuria, incontinence, stress urinary incontinence, retention, retrograde ejaculation, and urinary tract infection. [12], According to Zhang et al. An official website of the United States government. Moving forward it will be business as usual; the exceptional service you have come to expect from On Call. ThuLEP offers complete removal of the transition zone no matter what prostatic size. You may notice problems with Transurethral thulium laser enucleation versus resection of the prostate for treating benign prostatic hyperplasia: a retrospective study. This video is age-restricted and only available on YouTube. By using these two lasers, bleeding vessels are stopped by separating them from the capsule outside the prostate lobes (adenoma). Improvements in urinary symptoms from laser surgery are noticeable right away. A new laser technology called Thulium fibre laser (ThuLEP) provides a pulsed laser with a more optimal wavelength and a shallower depth of tissue penetration, resulting in better haemostatic properties. Received 2015 Jul 30; Accepted 2015 Oct 15. (2) Catheterization time: 25.22 h (224 patients within 24 h and 12 patients within 48 h). ThuLEP offers complete removal of the transition zone no matter what prostatic size. 48 Years Experience. Initially Holmium laser technology for prostate treatment in India came. 2022 Aug;40(8):2047-2053. doi: 10.1007/s00345-022-04046-8. The energies used for enucleation and resection were60and 120W, respectively. 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