Qian Sun1, Wenhuan Guo2, Di Cui2, Xiaohai Wang2, Yuan Ruan2, Fujun Zhao2, Shujie Xia2, Bangmin Han3, Yifeng Jing4. 1. Department of Urology, Shanghai First People's Hospital, Nanjing Medical University, No. 100, Haining Road, Shanghai, 200080, China. 2. Department of Urology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 100, Haining Road, Shanghai, 200080, China. 3. Department of Urology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 100, Haining Road, Shanghai, 200080, China. hanbm@163.com. 4. Department of Urology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, No. 100, Haining Road, Shanghai, 200080, China. jyf_123@163.com.
Abstract
PURPOSE: To compare the safety and efficacy of thulium laser enucleation of the prostate (ThuLEP) versus thulium laser resection of the prostate (TmLRP) in small prostates (≤ 30 g) and to test the validity of ThuLEP for bladder neck contracture (BNC). METHODS: A total of 115 patients with benign prostatic hyperplasia (BPH) (prostate size ≤ 30 g) were randomly assigned to ThuLEP (n = 56) or TmLRP (n = 59). All patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery. Baseline characteristics of the patients, perioperative data, postoperative outcomes and complications were assessed. RESULTS: Comparisons of the baseline and perioperative data demonstrated no significant differences between the ThuLEP and TmLRP groups. Significant improvement was noted in the International Prostate Symptom Score, quality of life, maximal urinary flow rate (Qmax) and post-void residual volume (PVR) in both groups at the 12-month follow-up, and assessment showed no differences in these parameters between the two groups. The TmLRP group showed a significantly higher rate (13.6%) of BNC than the ThuLEP group (1.8%; P = 0.045). There were no significant differences in other complications between the two groups (P > 0.05). CONCLUSIONS:ThuLEP and TmLRP are both safe and efficient procedures for the treatment of patients with small prostate volume, while ThuLEP can significantly reduce the risk of BNC in patients with a small prostate because the procedure enucleates adenomas without thermal damage to the bladder neck.
RCT Entities:
PURPOSE: To compare the safety and efficacy of thulium laser enucleation of the prostate (ThuLEP) versus thulium laser resection of the prostate (TmLRP) in small prostates (≤ 30 g) and to test the validity of ThuLEP for bladder neck contracture (BNC). METHODS: A total of 115 patients with benign prostatic hyperplasia (BPH) (prostate size ≤ 30 g) were randomly assigned to ThuLEP (n = 56) or TmLRP (n = 59). All patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery. Baseline characteristics of the patients, perioperative data, postoperative outcomes and complications were assessed. RESULTS: Comparisons of the baseline and perioperative data demonstrated no significant differences between the ThuLEP and TmLRP groups. Significant improvement was noted in the International Prostate Symptom Score, quality of life, maximal urinary flow rate (Qmax) and post-void residual volume (PVR) in both groups at the 12-month follow-up, and assessment showed no differences in these parameters between the two groups. The TmLRP group showed a significantly higher rate (13.6%) of BNC than the ThuLEP group (1.8%; P = 0.045). There were no significant differences in other complications between the two groups (P > 0.05). CONCLUSIONS:ThuLEP and TmLRP are both safe and efficient procedures for the treatment of patients with small prostate volume, while ThuLEP can significantly reduce the risk of BNC in patients with a small prostate because the procedure enucleates adenomas without thermal damage to the bladder neck.
Entities:
Keywords:
Benign prostatic hyperplasia; Bladder neck contracture; Small prostate; Thulium laser enucleation of the prostate; Thulium laser resection of the prostate
Authors: Anja C Reichelt; Rodrigo Suarez-Ibarrola; Thomas R W Herrmann; Arkadiusz Miernik; Dominik S Schöb Journal: World J Urol Date: 2020-12-02 Impact factor: 4.226