Thulium Laser Vaporization versus Vapoenucleation (without morcellation) Technique for BPH: Do We Have a Winner?
Bibliographic record
Abstract
Background and Objective The thulium laser surgery is a relatively new approach in which a wavelength of approximately 2 μm is emitted in continuous-wave mode, thus enabling the precise incision of tissue by using a wavelength that matches the water absorption peak of 1.92 μm in tissue. However, no published multinational study or other evidence definitively declares the superiority of thulium vaporization (ThuVAP) over thulium vapoenucle-ation (ThuVEP) without morcellator for better management of bothersome benign prostatic hyperplasia. The present study aims to evaluate the efficacy of vaporization and vapoenucleation (without a morcellator) in thulium laser prostatectomy for the treatment of benign prostatic hyperplasia. Methods A retrospective analysis of 82 patients who underwent thulium laser prostatectomy between February 2017 and January 2018 with ThuVAP and ThuVEP techniques was done and outcome measures analyzed were International Prostate Symptom Score (IPSS), quality-of-life score (QoL), maximum flow rate (Q max), post-void residual (PVRU), total operating time, laser time and resected tissue weight. Results No significant differences were noted between ThuVAP and ThuVEP in terms of post-operative prostate volume (22.4 vs. 21.7 mL) and post-operative prostate specific antigen (PSA) (2.54 vs. 1.85 ng/mL). Nonetheless, there were differences between the groups in total lasing time (56.5 vs. 44.8 min, p = 0.001) and total operative time (88.5 vs. 71.5 min, p= 0.001). There was also a significant difference in IPSS, QoL score, Q max, and PVRU at 6 weeks, 3 months, 6 months and 9 months after surgery. Conclusion ThuVEP provides a superior reduction of prostate volume and better short-term clinical outcomes than ThuVAP in the treatment of patients with benign prostatic hyperplasia. Furthermore, ThuVEP results in significantly lower urethral discomfort rates with significant improvement in IPSS as compared to ThuVAP which is maintained over time. The hospital stay and catheter indwelling time are shorter in the ThuVEP group and the complications associated with it appear to be lower than ThuVAP group.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".