Department of Urology and Surgical Nephrology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Treatment of huge benign prostatic hyperplasia (BPH) consists an actual
problem for urological community. Nowadays, open surgery is one of the basic surgical
methods in treatment of large BPH, but it is less used due to the modern laser techniques.
Spreading of laser surgery offers some new opprotunities for its treatment. Safety of
Thulium:YAG laser in transurethral vapoenucleation of the prostate in combination with its
efficiency assure a good alternative for clasic open surgery in BPH treatment.Aim of the study. Comparative assessment of the efficacy of transurethral Thulium:YAG laser
vapoenucleation of prostate (ThuVEP).
Materials and methods. 37 patients with average age of 67 years underwent surgical
treatment of large BPH at the Department of urology and surgical nephrology, State University
of Medicine and Pharmacy “Nicolae Testemițanu”. Patients were divided into two treatment
groups: ThuVEP (17 patients) and open simple prostatectomy (Fuller-Freyer procedure) (20
patients) and evaluated postoperatively at 3 months. Hemoglobin drop was also evaluated at
the first postoperative day.
Preoperative patients were investigated: PSA, IPSS, QoL, TRUS-P with PVR and Qmax.
Patients inclusion criteria: Prostate Volume ≥80cm3
, IPSS ≥16 and PVR ≥ 50ml, PSA≤4ng /
ml, QoL> 4, Qmax <8ml / s.
Results. Average duration of intervention: 79 min vs 63 min. The prostate volume decreased
postoperative on average from 82,2 cm3
to 31,3 cm3
vs 83,4 cm3
to 31,9 cm3
, there was an
increase of average Qmax from 8,2 to 20.3 ml / s vs 8,4 to 21,1 ml / s, and a decrease in mean
IPSS from 19,3 to 5.3 vs 20,1 to 5,4, and PVR diminished from 67.2 ml to 15,4 ml versus 68,1
to 17,4 ml, respectively. The period of transitional macrohematuria was 2,1 days vs 5,3 days
respectively. The duration of cateterization was 2,3 days in the first group and 8,3 days in the
second group. Mean hemoglobin drop was 2,1g/l in Group 1 vs 3,4g/l in Group 2.
Conclusions. ThuVEP is an effective alternative method in the treatment of large BPH.
Immediate postoperative results of ThuVEP are similar to the results in open simple
prostatectomy (Fuller-Freyer procedure). It is to mention a high safety profile characteristic for
ThuVEP and a reduced hemoglobin drop comparatively to clasic open surgery
