Thulium: YAG 2 mum cw laser prostatectomy: where do we stand?

Area of Science:

• Urology
• Minimally Invasive Surgery
• Laser Technology

Background:

• Benign prostatic obstruction (BPO) is commonly treated with Thulium:YAG (Tm:YAG) 2-micrometer continuous wave laser prostatectomy.
• Numerous studies confirm the efficacy of Tm:YAG laser prostatectomy, but varying terminology for similar surgical techniques complicates comparisons.
• A standardized nomenclature is needed to facilitate consistent reporting and comparison of surgical outcomes.

Purpose of the Study:

• To systematically review published data on Tm:YAG laser prostatectomy.
• To break down surgical techniques into core principles and define validated appellations.
• To propose a homogenous nomenclature for Tm:YAG laser prostatectomy techniques.

Main Methods:

• A systematic review of all peer-reviewed publications on Tm:YAG laser prostatectomy since 2005.
• Articles were analyzed and categorized based on the surgical approach.
• Data was synthesized to identify distinct surgical principles and outcomes.

Main Results:

• Sixteen publications were included, describing four main surgical principles: vaporization, resection, and enucleation.
• Follow-up data up to 24 months demonstrated durable functional results.
• Specific techniques identified include Tm:YAG Vaporization of the prostate (ThuVAP), Tm:YAG VapoResection of the prostate (ThuVaRP), and Tm:YAG VapoEnucleation of the prostate (ThuVEP).

Conclusions:

• Tm:YAG laser prostatectomy is an effective treatment for BPO.
• The authors propose "Tm:YAG laser enucleation of the prostate (ThuLEP)" as a standardized term for almost blunt enucleation.
• Further large-scale prospective studies are recommended, and the Urothulium Study Group was founded to guide future research.