Two-micron （thulium） laser resection of the prostate-tangerine technique （TmLRP-TT） is a transurethral procedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar t...Two-micron （thulium） laser resection of the prostate-tangerine technique （TmLRP-TT） is a transurethral procedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. We recently reported the primary results. Here we introduce this procedure in detail. A 70-W, 2-um （thulium） laser was used in continuous-wave mode. We joined the incision by making a transverse cut from the level of the verumontanum to the bladder neck, making the resection sufficiently deep to reach the surgical capsule, and resected the prostate into small pieces, just like peeling a tangerine. As we resected the prostate, the pieces were vaporized, sufficiently small to be evacuated through the reseetoscope sheath, and the use of the mechanical tissue morcellator was not required. The excellent hemostasis of the thulium laser ensured the safety of TmLRP-TT. No patient required blood transfusion. Saline irrigation was used intraoperatively, and no case of transurethral resection syndrome was observed. The bladder outlet obstruction had clearly resolved after catheter removal in all cases. We designed the tangerine technique and proved it to be the most suitable procedure for the use of thulium laser in the treatment of benign prostatic hyperplasia （BPH）. This procedure, which takes less operative time than standard techniques, is safe and combines efficient cutting and rapid organic vaporization, thereby showing the great superiority of the thulium fiber laser in the treatment of BPH. It has been proven to be as safe and efficient as transurethral resection of the prostate （TURP） during the 1-year follow-up.展开更多
Treatment of patients with lower urinary tract symptoms （LUTS） secondary to benign prostatic hyperplasia （BPH） may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, whic...Treatment of patients with lower urinary tract symptoms （LUTS） secondary to benign prostatic hyperplasia （BPH） may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of thulium laser enucleation of the prostate （ThuLEP） on sexual function and retrograde ejaculation in patients with LUTS secondary to BPH. We performed a prospective study in 110 consecutive patients who had undergone ThuLEP to analyze changes in sexual function and urinary symptoms. To evaluate changes in erection and ejaculation, and the effect of urinary symptoms on the quality of life （QoL）, five validated questionnaires were used： the ICIQ-MLUTSsex, MSHQ-EjD, International Index of Erectile Function 5, International Prognostic Scoring System （IPSS） questionnaire, and QoL index of the intraclass correlation coefficients. Patients also underwent IPSS and flowmetry to assess the outcome of flow. Patients were evaluated before surgery and 3-6 months after ThuLEP, whereas those with previous abdominal surgery were excluded. The patients＇ mean age was 67.83 years. Postoperative urinary symptoms improved after surgery. No significant differences in erectile function before and after surgery were observed. As compared with other techniques described in the literature, the percentage of patients with conserved ejaculation increased by 52.7% after ThuLEP. ThuLEP positively affects urinary symptoms and their effect on the QoL of patients as assessed by questionnaire scores. While endoscopic management of BPH （e.g. transurethral resection of the prostate） causes retrograde ejaculation in most patients, those who undergo ThuLEP have conserved ejaculation and erectile function.展开更多
Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the co...Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.展开更多
The 2-1μm thulium laser resection of the prostate-tangerine technique （TmLRP-TT） has been introduced as a minimally invasive treatment for benign prostatic hyperplasia （BPH）. This study was undertaken to assess t...The 2-1μm thulium laser resection of the prostate-tangerine technique （TmLRP-TT） has been introduced as a minimally invasive treatment for benign prostatic hyperplasia （BPH）. This study was undertaken to assess the clinical efficacy and safety of TmLRP-TT for the treatment of BPH patients with previously negative transrectal prostate biopsy. A prospective analysis of 51 patients with previously negative transrectal prostate biopsy who underwent surgical treatment using TmLRP-TT was performed from December 2011 to December 2013. Preoperative status, surgical details, and perioperative complications were recorded. The follow-up outcome was evaluated with subjective and objective tests at I and 6 months. TmLRP-TT was successfully completed in all patients. Mean prostate volume, operative duration, and catheterization time were 93.3 ± 37.9 ml, 69.5 ± 39.5 min, and 6.5 ± 1.3 days, respectively. The mean International Prostate Symptom Score, quality of life score, maximum urinary flow rate, and post-void residual urine volume changed notably at 6-month follow-up （22.5 ± 6.9 vs 6.1 ± 3.2, 4.8 ± 1.3 vs 1.1 ± 0.9, 7.3 ± 4.5 vs 18.9 ± 7.1 ml s^-1, and 148.7 ± 168.7 vs 28.4 ± 17.9 ml）. Two （3.9%） patients required blood transfusion perioperatively, while 3 （5.9%） patients experienced transient hematuria postoperatively, and 2 （3.9%） patients received 3 days recatheterization due to clot retention. TmLRP-TT is a safe and effective minimally invasive technique for patients with previously negative transrectal prostate biopsy during the 6-month follow-up. This promising technology may be a feasible surgical method for previously negative transrectal prostate biopsy in the future.展开更多
A diode-pumped single frequcncy Tm,Ho：YLF laser operating at an eye-safe wavelength of 2 μm has been developed. Temperature of the laser crystal was controlled at room temperature with a thermoelectric cooler. The l...A diode-pumped single frequcncy Tm,Ho：YLF laser operating at an eye-safe wavelength of 2 μm has been developed. Temperature of the laser crystal was controlled at room temperature with a thermoelectric cooler. The line-width narrowing elements were two solid uncoated fused silica etalons whose thicknesses were 1 and 0.1 mm, respectively. Continuous wave single frequency power of 113 mW was obtained.展开更多
A series of fluorotellurite glasses based on（81–x）Te O2-（10＋x）KF-9La2O3（TKL）, where x=0 mol.%, 5 mol.%, 10 mol.%, 15 mol.%, doped with 2000 ppm Tm2O3, were prepared by the conventional melt quenching method.Th...A series of fluorotellurite glasses based on（81–x）Te O2-（10＋x）KF-9La2O3（TKL）, where x=0 mol.%, 5 mol.%, 10 mol.%, 15 mol.%, doped with 2000 ppm Tm2O3, were prepared by the conventional melt quenching method.The influence of KF content on the thermal stability and optical spectroscopic properties of the Tm3＋ doped fluorotellurite glasses were investigated by differential scanning calorimetry（DSC）, X-ray diffraction（XRD）, density measurement, Fourier transform infrared spectroscopy（FTIR）, UV-VIS-NIR optical spectroscopy and fluorescence spectroscopy.Judd-Ofelt intensity parameters of Tm3＋ in as-prepared glasses were determined and used to calculate the spontaneous emission probabilities and the radiative lifetime for the 4f-4f transitions of the Tm3＋ ions.Stimulated emission cross sections in the 1470 nm region（σse） were evaluated by Füchtbauer-Ladenburg formula.The results showed that KF substitution of Te O2 was beneficial to improving the thermal stability, decreasing glass density and reducing the content of OH related groups for the investigated fluorotellurite glasses.The glass with composition of 66 Te O2-25KF-9La2O3（named TKL25） had the longest radiative lifetime of the 3H4（361 μs） and the largest FWHM×σse value（420.07×10–28 cm3）, which made it a promising material for S-band fiber amplifiers.展开更多
文摘Two-micron （thulium） laser resection of the prostate-tangerine technique （TmLRP-TT） is a transurethral procedure that uses a thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. We recently reported the primary results. Here we introduce this procedure in detail. A 70-W, 2-um （thulium） laser was used in continuous-wave mode. We joined the incision by making a transverse cut from the level of the verumontanum to the bladder neck, making the resection sufficiently deep to reach the surgical capsule, and resected the prostate into small pieces, just like peeling a tangerine. As we resected the prostate, the pieces were vaporized, sufficiently small to be evacuated through the reseetoscope sheath, and the use of the mechanical tissue morcellator was not required. The excellent hemostasis of the thulium laser ensured the safety of TmLRP-TT. No patient required blood transfusion. Saline irrigation was used intraoperatively, and no case of transurethral resection syndrome was observed. The bladder outlet obstruction had clearly resolved after catheter removal in all cases. We designed the tangerine technique and proved it to be the most suitable procedure for the use of thulium laser in the treatment of benign prostatic hyperplasia （BPH）. This procedure, which takes less operative time than standard techniques, is safe and combines efficient cutting and rapid organic vaporization, thereby showing the great superiority of the thulium fiber laser in the treatment of BPH. It has been proven to be as safe and efficient as transurethral resection of the prostate （TURP） during the 1-year follow-up.
文摘Treatment of patients with lower urinary tract symptoms （LUTS） secondary to benign prostatic hyperplasia （BPH） may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of thulium laser enucleation of the prostate （ThuLEP） on sexual function and retrograde ejaculation in patients with LUTS secondary to BPH. We performed a prospective study in 110 consecutive patients who had undergone ThuLEP to analyze changes in sexual function and urinary symptoms. To evaluate changes in erection and ejaculation, and the effect of urinary symptoms on the quality of life （QoL）, five validated questionnaires were used： the ICIQ-MLUTSsex, MSHQ-EjD, International Index of Erectile Function 5, International Prognostic Scoring System （IPSS） questionnaire, and QoL index of the intraclass correlation coefficients. Patients also underwent IPSS and flowmetry to assess the outcome of flow. Patients were evaluated before surgery and 3-6 months after ThuLEP, whereas those with previous abdominal surgery were excluded. The patients＇ mean age was 67.83 years. Postoperative urinary symptoms improved after surgery. No significant differences in erectile function before and after surgery were observed. As compared with other techniques described in the literature, the percentage of patients with conserved ejaculation increased by 52.7% after ThuLEP. ThuLEP positively affects urinary symptoms and their effect on the QoL of patients as assessed by questionnaire scores. While endoscopic management of BPH （e.g. transurethral resection of the prostate） causes retrograde ejaculation in most patients, those who undergo ThuLEP have conserved ejaculation and erectile function.
文摘Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.
文摘The 2-1μm thulium laser resection of the prostate-tangerine technique （TmLRP-TT） has been introduced as a minimally invasive treatment for benign prostatic hyperplasia （BPH）. This study was undertaken to assess the clinical efficacy and safety of TmLRP-TT for the treatment of BPH patients with previously negative transrectal prostate biopsy. A prospective analysis of 51 patients with previously negative transrectal prostate biopsy who underwent surgical treatment using TmLRP-TT was performed from December 2011 to December 2013. Preoperative status, surgical details, and perioperative complications were recorded. The follow-up outcome was evaluated with subjective and objective tests at I and 6 months. TmLRP-TT was successfully completed in all patients. Mean prostate volume, operative duration, and catheterization time were 93.3 ± 37.9 ml, 69.5 ± 39.5 min, and 6.5 ± 1.3 days, respectively. The mean International Prostate Symptom Score, quality of life score, maximum urinary flow rate, and post-void residual urine volume changed notably at 6-month follow-up （22.5 ± 6.9 vs 6.1 ± 3.2, 4.8 ± 1.3 vs 1.1 ± 0.9, 7.3 ± 4.5 vs 18.9 ± 7.1 ml s^-1, and 148.7 ± 168.7 vs 28.4 ± 17.9 ml）. Two （3.9%） patients required blood transfusion perioperatively, while 3 （5.9%） patients experienced transient hematuria postoperatively, and 2 （3.9%） patients received 3 days recatheterization due to clot retention. TmLRP-TT is a safe and effective minimally invasive technique for patients with previously negative transrectal prostate biopsy during the 6-month follow-up. This promising technology may be a feasible surgical method for previously negative transrectal prostate biopsy in the future.
基金This work was supported by the Scientic Re-search Foundation of Harbin Engineering Univer-sity (HEUF04014)
文摘A diode-pumped single frequcncy Tm,Ho：YLF laser operating at an eye-safe wavelength of 2 μm has been developed. Temperature of the laser crystal was controlled at room temperature with a thermoelectric cooler. The line-width narrowing elements were two solid uncoated fused silica etalons whose thicknesses were 1 and 0.1 mm, respectively. Continuous wave single frequency power of 113 mW was obtained.
基金Project supported by Hunan Provincial Natural Science Foundation of China(2015JJ3004)National Natural Science Foundation of China(21276028)
文摘A series of fluorotellurite glasses based on（81–x）Te O2-（10＋x）KF-9La2O3（TKL）, where x=0 mol.%, 5 mol.%, 10 mol.%, 15 mol.%, doped with 2000 ppm Tm2O3, were prepared by the conventional melt quenching method.The influence of KF content on the thermal stability and optical spectroscopic properties of the Tm3＋ doped fluorotellurite glasses were investigated by differential scanning calorimetry（DSC）, X-ray diffraction（XRD）, density measurement, Fourier transform infrared spectroscopy（FTIR）, UV-VIS-NIR optical spectroscopy and fluorescence spectroscopy.Judd-Ofelt intensity parameters of Tm3＋ in as-prepared glasses were determined and used to calculate the spontaneous emission probabilities and the radiative lifetime for the 4f-4f transitions of the Tm3＋ ions.Stimulated emission cross sections in the 1470 nm region（σse） were evaluated by Füchtbauer-Ladenburg formula.The results showed that KF substitution of Te O2 was beneficial to improving the thermal stability, decreasing glass density and reducing the content of OH related groups for the investigated fluorotellurite glasses.The glass with composition of 66 Te O2-25KF-9La2O3（named TKL25） had the longest radiative lifetime of the 3H4（361 μs） and the largest FWHM×σse value（420.07×10–28 cm3）, which made it a promising material for S-band fiber amplifiers.
