Thulium Laser Prostate Enucleation in Refractory Urinary Retention: Operative and Functional Outcomes in a Large Cohort of Patients

Luca Carmignani, Antonio Luigi Pastore, Stefano Carlo Maria Picozzi, Elisabetta Finkelberg, Dario Ratti, Damiano Vizziello, Maria Lucia Schirinzi, Antonino Saccà, Francesca Pisano, Serena Maruccia

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Abstract

Objective: To evaluate the functional and operative results of thulium laser enucleation of the prostate (ThuLEP) in patients with indwelling catheters for refractory urinary retention. Methods: Patients with indwelling catheter, undergoing ThuLEP for benign prostate hyperplasia, were prospectively enrolled. Every episode of urinary retention was treated with urinary catheter positioning followed by at least 2 attempts of catheter removal. Patients were investigated with flowmetry and the self-administered International Prostate Symptom Score questionnaire at 30 and 90 days following ThuLEP. Results: Three hundred eighty-one patients underwent ThuLEP, and 99 of these had indwelling catheters, but only 93 (24%) were eligible according to the inclusion criteria. In 46 patients the bladder catheter was removed on the first postoperative day, in 31 patients on the second postoperative day, in 5 patients on the third postoperative day, in 6 patients on the fourth postoperative day, in 1 patient on the fifth postoperative day, and in 2 patients each on the sixth and seventh postoperative days. The average hospital stay was 2.3 (±1.7) days. No patients undergoing ThuLEP, at the 90-day follow-up, required further catheterization. Flowmetry showed significant improvement in all parameters, and the mean International Prostate Symptom Score dropped from 21.33 preoperatively to 3.2 (P = .004) at 90 days postoperatively. Conclusion: This prospective study shows that ThuLEP is a safe and effective approach in refractory urinary retention patients. In our case series, no patients required postoperative intermittent catheterization. All functional outcomes investigated reported a statistical significant improvement.

Original languageEnglish
JournalUrology
DOIs
Publication statusAccepted/In press - Dec 21 2015

ASJC Scopus subject areas

  • Urology

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    Carmignani, L., Pastore, A. L., Picozzi, S. C. M., Finkelberg, E., Ratti, D., Vizziello, D., Schirinzi, M. L., Saccà, A., Pisano, F., & Maruccia, S. (Accepted/In press). Thulium Laser Prostate Enucleation in Refractory Urinary Retention: Operative and Functional Outcomes in a Large Cohort of Patients. Urology. https://doi.org/10.1016/j.urology.2016.02.015