Videosurgery
New super-pulse thulium laser for the treatment of benign prostatic hyperplasia and bladder stones: our first experience
Francesco Persico1-2, Alberto Saita1, Roberto Peschechera1, Pietro Diana1, Giovanni Lughezzani1, 3, Giorgio Ferruccio Guazzoni1, 3, Paolo Casale1
1Humanitas Clinical and Research Center – IRCCS, Department of Urology, Rozzano, Milan, Italy
2University of Naples Federico II, Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Naples, Italy
3Humanitas University, Department of Biomedical Sciences, Rozzano, Milan, Italy
Citation: Persico F, Saita A, Peschechera R, et al. New super-pulse thulium laser for the treatment of benign prostatic hyperplasia and bladder stones: our first experience. www.ceju.online/journal/2020/laser-thulium-bladder-stones-benign-prostatic-hyperplasia-thulep--2116.php
Key Words: benign prostatic hyperplasia • bladder stones • laser • lower urinary tract symptoms •  • thulium • thulep

In this video, we presented our first experience with Soltive PremiumTM (OlympusTM), a new 60-W super-pulse thulium fiber laser that can be used in the treatment of benign prostatic hyperplasia(BPH) and urinary tract stones. We describe the case of a 63-year-old man with persistent voiding urinary symptoms despite medical therapy with dutasteride and tamsulosin. Ultrasonography estimated a prostatic volume of 90 ml and revealed the presence of four bladder stones. We used the new 60-W super-pulse thulium fiber laser (Soltive PremiumTM) with a 550 μm disposable laser fiber and a 28 Fr continuous flow resectoscope. The enucleation was performed according to Gilling's three-lobe technique. Total operative time was 110 minutes. Laser setting was 1 Joule × 60 Hertz (60 Watt) short pulse for cystolithotripsy and 1 Joule × 30 Hertz (30 Watt) long pulse for prostate enucleation. Morcellation was performed with the Versacut system (Lumenis). Postoperative catheterization time was 48 hours and the patient was discharged the day after catheter removal. There were no perioperative complications. Pre- and post-procedure haemoglobin levels were 15.6 and 15.4 g/dL, respectively. At follow-up 1 month later, the patient reported good urinary flow with mild irritative symptoms that did not require any specific therapy. The uroflowmetry showed a maximum voiding flow rate of 24 ml/s with a postvoid resisdual (PVR) of 10 ml. Soltive PremiumTM may represent a feasible and effective tool for the surgical management of BPH and bladder stones. This technology seems particularly advantageous for high intra-operative safety and may become an important milestone for BPH treatment.

Article history
Submitted: 16 November, 2020
Accepted: 22 February, 2021
Published online: 3 March, 2021
doi: 10.5173/ceju.2021.330.R2
Corresponding author
Francesco Persico
email: francesco.persico90@gmail.com
Conflicts of interest:  The authors declare no conflicts of interest.
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