A Comparison of the First 60 Enucleation Cases Using a Thulium Fiber Laser without a Mentor to a Transurethral Resection of the Prostate (TURP) and Open Prostatectomy, and the Learning Curve
Abstract
:1. Introduction
2. Materials and Methods
2.1. Surgical Technique
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Group A (n = 60) Median (Min–Max) | Group B (n = 88) Median (Min–Max) | Group C (n = 81) Median (Min–Max) | p | |
---|---|---|---|---|
Age, years (mean ± STD) | 67.1 ± 7.1 | 68.9 ± 6.8 | 67.6 ± 7.1 | 0.368 |
Prostatic volume, cc | 90 (80–120) | 108 (87–120) | 84 (80–107) | <0.001 *αβγ |
PSA preoperative, ng/mL | 4.2 (3.7–5.6) | 5.3 (3.4–5.9) | 3.5 (3.4–4.5) | <0.001 *αβγ |
IPSS, score | 23 (20–30) | 23 (20–30) | 22 (17–30) | 0.606 |
IPSS QoL, score | 4 (3–6) | 5 (3–6) | 4 (3–6) | 0.605 |
Qmax, mL/s | 7.8 (4.1–13.7) | 7.6 (3.1–12.6) | 7.6 (3.8–13.9) | 0.685 |
PVRU, mL | 92.5 (30–230) | 90 (10–230) | 90 (10–220) | 0.575 |
Group A (n = 60) Median (Min–Max) | Group B (n = 88) Median (Min–Max) | Group C (n = 81) Median (Min–Max) | p | |
---|---|---|---|---|
Operation time, min | 130 (40–180) | 110 (60–160) | 100 (50–130) | <0.001 *αβγ |
Weight of tissue specimen, g | 73 (65–98) | 89 (72–99) | 53 (50–67) | <0.001 *αβγ |
Resection speed, g/min | 0.6 (0.4–1.8) | 0.8 (0.5–1.6) | 0.6 (0.4–1.1) | <0.001 *αγ |
Catheterization time, days | 1 (1–5) | 5 (5–9) | 4 (3–8) | <0.001 *αβγ |
Hospital stay, days | 1 (1–5) | 5 (4–9) | 1 (1–6) | <0.001 *αγ |
Hemoglobin level decrease, g/dL | 1.3 (0.1–2.8) | 2.9 (1.6–4.4) | 2.1 (0.8–3.6) | <0.001 *αβγ |
Transfusion, n (%) | 1 (1.7%) | 4 (4.5%) | 2 (2.5%) | 0.564 |
Early Complication | ||||
Clavien–Dindo I | 0.775 | |||
Short-term SUI | 7 (11.7%) | 4 (4.5%) | 7 (8.6%) | |
Short-term UUI | 3 (5%) | 9 (10.2%) | 5 (6.2%) | |
Injury of bladder-wall | 1 (1.7%) | 0 (0%) | 0 (0%) | |
Injury of ureteral orifice | 1 (1.7%) | 1 (1.1%) | 1 (1.2%) | |
Clavien–Dindo II | 0.159 | |||
Urinary tract infection | 2 (3.3%) | 8 (9.1%) | 4 (4.9%) | |
Acute urinary retention | 1 (1.7%) | 2 (2.3%) | 4 (4.9%) | |
Clot retention | 1 (1.7%) | 4 (4.5%) | 8 (9.9%) | |
Late Complication | ||||
SUI n (%) | 1 (1.7%) | 6 (6.8%) | 4 (4.9%) | 0.354 |
Urethral stricture or bladder neck contraction n (%) | 1 (1.7%) | 1 (1.1%) | 5 (6.2%) | 0.126 |
Group A (n = 60) Median (Min–Max) | Group B (n = 88) Median (Min–Max) | Group C (n = 81) Median (Min–Max) | p | |
---|---|---|---|---|
Prostatic volume, cc | 11 (7–24) | 13 (7–24) | 18 (9–28) | <0.001 *αβγ |
PSA postoperative, ng/mL | 0.7 (0.5–1.3) | 2 (0.7–1.5) | 1.1 (0.5–1.6) | <0.001 *αβγ |
PSA decrease, % | 85.2 (70.9–89.3) | 81.5 (65.8–86.7) | 69.8 (55.6–84.5) | <0.001 *αβγ |
IPSS, score | 5.5 (3–14) | 6 (3–14) | 7 (4–15) | <0.001 *βγ |
IPSS QoL, score | 1 (1–2) | 1.5 (1–2) | 2 (1–3) | 0.087 |
Qmax, mL/s | 18 (13–29.1) | 18.2 (13.2–30.2) | 14.4 (10.4–26.0) | <0.001 *βγ |
PVRU, mL | 10 (0–40) | 20 (0–30) | 10 (0–40) | 0.001 *βγ |
Group 1 (1–20) Median (Min-Max) | Group 2 (21–40) Median (Min-MAX) | Group 3 (41–60) Median (Min-Max) | p | |
---|---|---|---|---|
Operation time, min | 140 (120–180) | 115 (70–140) | 115 (40–150) | <0.001 *αγ |
Qmax postoperative, mL/s | 19.8 (13–29.1) | 17.7 (14.2–23.7) | 17.9 (14.6–22.4) | 0.220 |
IPSS postoperative, score | 6 (3–10) | 5 (3–10) | 5.5 (3–14) | 0.978 |
IPSS QoL postoperative, score | 1 (1–2) | 1 (1–2) | 1 (1–2) | 0.935 |
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Bulut, E.C.; Elmas, B.; Koparal, M.Y.; Coşkun, Ç.; Aydın, U.; Erten, K.Ş.; Çetin, S.; Alishov, S.; Atan, A.; Yeşil, S.; et al. A Comparison of the First 60 Enucleation Cases Using a Thulium Fiber Laser without a Mentor to a Transurethral Resection of the Prostate (TURP) and Open Prostatectomy, and the Learning Curve. Medicina 2024, 60, 1356. https://doi.org/10.3390/medicina60081356
Bulut EC, Elmas B, Koparal MY, Coşkun Ç, Aydın U, Erten KŞ, Çetin S, Alishov S, Atan A, Yeşil S, et al. A Comparison of the First 60 Enucleation Cases Using a Thulium Fiber Laser without a Mentor to a Transurethral Resection of the Prostate (TURP) and Open Prostatectomy, and the Learning Curve. Medicina. 2024; 60(8):1356. https://doi.org/10.3390/medicina60081356
Chicago/Turabian StyleBulut, Ender Cem, Burak Elmas, Murat Yavuz Koparal, Çağrı Coşkun, Uğur Aydın, Kadir Şerefhan Erten, Serhat Çetin, Sabuhi Alishov, Ali Atan, Süleyman Yeşil, and et al. 2024. "A Comparison of the First 60 Enucleation Cases Using a Thulium Fiber Laser without a Mentor to a Transurethral Resection of the Prostate (TURP) and Open Prostatectomy, and the Learning Curve" Medicina 60, no. 8: 1356. https://doi.org/10.3390/medicina60081356