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Inicio Actas Urológicas Españolas (English Edition) Comparative study between thulium laser (Tm: YAG) 150W and Greenlight laser (LBO...
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Vol. 41. Issue 3.
Pages 188-193 (April 2017)
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Vol. 41. Issue 3.
Pages 188-193 (April 2017)
Original article
Comparative study between thulium laser (Tm: YAG) 150W and Greenlight laser (LBO: ND-YAG) 120W for the treatment of benign prostatic hyperpplasia: Short-term efficacy and security
Estudio comparativo entre láser tulio (Tm: YAG) 150W y láser verde (LBO: ND-YAG) 120W para el tratamiento de la hiperplasia benigna de próstata: eficacia y seguridad a corto plazo
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J.L. Palmero-Martí, J. Panach-Navarrete
Corresponding author
jorpanav22@gmail.com

Corresponding author.
, L. Valls-González, A. Ganau-Ituren, J. Miralles-Aguado, A. Benedicto-Redón
Servicio de Urología, Hospital Universitario de La Ribera, Alzira, Valencia, Spain
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Tables (3)
Table 1. Preoperative characteristics in both study groups.
Table 2. Difference of postoperative complications in both study groups.
Table 3. Difference of failures in both study groups.
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Abstract
Objective

To compare the results of efficacy and safety of thulium laser 150W against Greenlight laser 120W in the treatment of short term benign prostatic hyperplasia (12 months after surgery).

Material and methods

This is a retrospective observational study where men who underwent the surgical technique of prostate vaporization over a period of four years in our center are included. The homogeneity of the sample was checked, and postoperative complications (acute urinary retention, reentry, need for transfusion), failures per year of surgery (reoperation, peak flow <15ml/s, no improvement in comparing the I-PSS), and decreased PSA were compared a year after surgery. A bivariate analysis using Chi-square and t-Student was carried out.

Results

116 patients were treated with thulium and 118 with green laser. The sample was homogeneous for preoperative variables (p>0.05). No differences in complications were observed: in urine acute retention, 4.3% with thulium and 6.8% with green laser (p=0.41); in readmissions, 2.6% with thulium and 1.7% with green laser (p=0.68); in need for transfusion, 2.6% with thulium and 0% with green laser (p=0.12). No differences were observed in the percentage of patients reoperation (1.7% in the group of thulium, 5.1% in the green laser, p=0.28); or in individuals with Qmáx less than 15ml/sec (6.9% with thulium, 6.77% with green laser, p=0.75), or in the absence of improvement in the IPSS (5, 2% with thulium, 3.4% with green laser, p=0.65). There was also no difference in the levels of PSA in ng/mL a year after surgery: with thulium 2.78±2.09 and with green laser 1.83±1.48 (p=0.75).

Conclusions

Prostate vaporization with thulium laser 150W is comparable to that made with green laser 120W for the treatment of lower urinary tract symptoms caused by BPH, being both effective and safe techniques to 12 months after surgery. Future prospective randomized studies are needed to confirm this conclusion on both techniques.

Keywords:
Thulium laser
Green laser
Benign hyperplasia prostate
Resumen
Objetivo

Comparar los resultados de eficacia y seguridad del láser tulio 150W frente a láser verde 120W en el tratamiento de la hiperplasia benigna de próstata a corto plazo (12 meses de la cirugía).

Material y métodos

Estudio retrospectivo observacional, donde se incluyen varones intervenidos con la técnica de fotovaporización prostática durante un periodo de 4 años en nuestro centro. Se comprobó la homogeneidad de la muestra, y se compararon las complicaciones postoperatorias (retención aguda de orina, reingreso, necesidad de transfusión), los fracasos al año de la cirugía (reintervenciones, flujo máximo<15ml/seg, ausencia de mejoría en el I-PSS) y disminución de PSA al año de la cirugía. Análisis bivariante mediante Chi-cuadrado y «t» de Student.

Resultados

Ciento dieciséis pacientes tratados con tulio y 118 con láser verde. Muestra homogénea para variables preoperatorias (p>0,05). No se objetivaron diferencias en las complicaciones: en retenciones agudas de orina, 4,3% con tulio y 6,8% con láser verde (p=0,41); en reingresos 2,6% con tulio y 1,7% con láser verde (p=0,68); en necesidad de transfusión 2,6% con tulio y 0% con láser verde (p=0,12). Tampoco se observaron diferencias en el porcentaje de pacientes reintervenidos (1,7% en el grupo de tulio, 5,1% en el de láser verde, p=0,28), ni en el de individuos con Qmáx menor de 15ml/seg (6,9% con tulio, 6,77% con láser verde, p=0,75), ni en el de ausencia de mejoría del I-PSS (5,2% con tulio, 3,4% con láser verde, p=0,65). Tampoco hubo diferencia en los niveles de PSA en ng/ml al año de la cirugía: con tulio 2,78±2,09 y con láser verde 1,83±1,48 (p=0,75).

Conclusiones

La fotovaporización prostática con láser tulio 150W es comparable a la realizada con láser verde de 120W para el tratamiento de los síntomas obstructivos del tracto urinario inferior por HBP, siendo ambas técnicas eficaces y seguras a los 12 meses de la intervención. Futuros estudios prospectivos aleatorizados son necesarios para confirmar esta conclusión sobre ambas técnicas.

Palabras clave:
Láser tulio
Láser verde
Hiperplasia benigna de próstata

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