Holmium Laser Enucleation of the Prostate Versus Thulium Laser Enucleation of the Prostate for the Treatment of Large-volume Prostates > 80 ml: 18-month Follow-up Results

Overview

Journal World J Urol

Specialty Urology

Date 2019 Sep 11

PMID 31502032

Citations 24

Authors

Junjie Zhang

Zhenyu Ou

Xiaobo Zhang

Wei He

Ruizhe Wang

Miao Mo

Lingxiao Chen

Ran Xu

Shusuan Jiang

Xiaoyan Peng

Lin Qi

Long Wang

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the perioperative and functional outcomes of holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP) for the treatment of large-volume benign prostatic hyperplasia (BPH) (> 80 ml).

Methods: A total of 116 consecutive patients with BPH were randomized to be treated surgically with either HoLEP (n = 58) or ThuLEP (n = 58), following the classical three-lobe enucleation technique. Follow-up was assessed at 1, 3, 6, 12 and 18 months after surgery.

Results: At 18 months, the lower urinary tract symptom index was improved significantly in both groups compared with the baseline values. The operative time (78.4 ± 8.0 vs. 71.4 ± 6.4 min) and enucleation time (61.2 ± 5.4 vs. 56.4 ± 8.4 min) were significantly shorter for ThuLEP compared to HoLEP (both p < 0.001). There were no significant differences between the two groups regarding morcellation time, resected weight, hemoglobin decrease, catheter time and hospital stay (p > 0.05). The HoLEP and ThuLEP groups had equivalent International Prostate Symptom Scores (3 [3-3] vs. 3 [3-3], p = 0.776), quality of life (1 [1-2] vs. 2 [1-2], p = 0.809), Qmax (25.3 ± 4.8 ml/s vs. 24.7 ± 4.4 ml/s, p = 0.470), postvoid residual urine (PVR) (6.1 [2.6-20.8] vs. 7.7 [3.1-22.8] ml, p = 0.449) and PSA (0.84 ± 0.32 vs. 0.90 ± 0.34 ml, p = 0.309) at 18 months postoperatively.

Conclusion: Both HoLEP and ThuLEP relieve lower urinary tract symptoms in a comparable way with high efficacy and safety. ThuLEP was statistically superior to HoLEP in operation time and enucleation time, although the differences were clinically negligible.

Citing Articles

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PMID: 40067530 DOI: 10.1007/s00345-025-05536-1.

Refining surgical strategies in ThuLEP for BPH: a propensity score matched comparison of En-bloc, three lobes, and two lobes techniques.

Cantiello F, Crocerossa F, Alba S, Carbonara U, Pandolfo S, Falagario U World J Urol. 2024; 42(1):431.

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Wang J, Wu S, Wang M Iran J Public Health. 2024; 53(3):495-507.

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The safety and efficacy of five surgical treatments in prostate enucleation: a network meta-analysis.

Chen Y, Hua W, Huang Y, Shen X, You J, Ding X BMC Urol. 2024; 24(1):128.

PMID: 38886739 PMC: 11181543. DOI: 10.1186/s12894-024-01517-5.

Comparison of HoLEP, ThuLEP and ThuFLEP in the treatment of benign prostatic obstruction: a propensity score-matched analysis.

Aybal H, Yilmaz M, Barlas I, Duvarci M, Tuncel A, Tunc L World J Urol. 2024; 42(1):374.

PMID: 38871959 DOI: 10.1007/s00345-024-05082-2.

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