[A comparison between enucleation of the prostate using holmium and thulium laser in volume over 80 cc: retrospective clinical study with 12-months follow-up].

ABSTRACT

AIM: The aim of our study was to evaluate efficiency of thulium laser enucleation of the prostate (ThuLEP) for the treatment of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A retrospective analysis of 112 patients with BPH who underwent ThuLEP (n=60) or holmium laser enucleation of the prostate (HoLEP) (n=52) at our institution from January 2017 to June 2017 was carried out. The perioperative data and complication rate were assessed. Severity of lower urinary tract symptom (LUTS) was evaluated after 1, 6 and 12 months using International Prostate Symptom Score [I-PSS], quality-of-life [QoL] score and maximum flow rate [Qmax]. To shorten learning curve, we modified the technique and simplified the intervention. To reduce noise during surgery, we performed ThuLEP using Vela XL. RESULTS: There were significant differences in pre- and perioperative parameters, including operative time (113.15+/-12.14 vs. 118.08+/-15.76 min, p=0.46), decrease in serum sodium concentration (3.49+/-0.83 vs. 3.48+/-0.84 mmol/L, P=0.97), hemoglobin drop (1.37+/-0.18 vs. 1.43+/-0.38 g/dL, p=0.65), catheterization time (2.15+/-0.38 vs. 2.27+/-0.39 days, p=0.52) and hospital stay (6.95+/-0.82 vs 7.56+/-1.36 days, p=0.25) between the two groups (ThuLEP and HoLEP). Compared with the HoLEP group, intraoperative noise was lower in ThuLEP group (47.22+/-10.31 vs. 59.45+/-9.65 db, p<0.05). At 1-, 6- and 12 months follow-up, the LUTS severity (I-PSS, QoL score and Qmax) were significantly improved in both groups in comparison with the baseline values. Furthermore, there was no difference in LUTS severity between two groups (p>0.05). CONCLUSION: ThuLEP is comparable to the holmium laser in terms of efficiency, safety and indications and represent minimally invasive treatment option for patients with LUTS secondary to BPH.