Thulium laser enucleation of prostate (ThuLEP): efficacy and safety evaluation in patients with a prostate volume more than 80 cm3

Abstract

BACKGROUND: Benign prostatic hyperplasia is a common condition in men over 60 years of age. The gold standard for the treatment of benign prostatic hyperplasia up to 80 cm3 is transurethral resection of the prostate. At the same time, with a prostate volume of more than 80 cm3, the choice of the optimal method of surgical treatment of benign prostatic hyperplasia is a matter of debate. AIM: Evaluation of the efficacy and safety of thulium laser enucleation of the prostate (ThuLEP) in patients with benign prostatic hyperplasia with a prostate volume of more than 80 cm3. MATERIALS AND METHODS: The study involved 75 patients with benign prostatic hyperplasia aged 64 to 83 years (mean age 70.4 years) with a prostate volume of 80 to 215 cm3 (mean 123.9 cm3). All patients underwent ThuLEP using a thulium fiber laser FiberLase U1 with a power of 120 W. Control examinations were performed 3 and 6 months after the surgery. RESULTS: The duration of surgery averaged 84.7 minutes and ranged from 57 to 135 minutes. The duration of the urethral catheter after surgery averaged 2.8 days. The frequency of intra- and postoperative complications was low, none of the patients required blood transfusion, as well as repeated surgery to coagulate the vessels of the prostate bed. In 3 (4%) patients, superficial damage to the bladder wall occurred during marcellation, which required coagulation of the injury site. All recorded complications belonged to groups I and II according to the Clavien Dindo scale. Examinations carried out after 3 and 6 months showed a significant decrease in the severity of voiding disorders, an increase in the quality of life and an improvement in the outflow of urine from the bladder compared with the baseline. CONCLUSIONS: The results of the study showed high clinical efficacy and safety of the use of thulium laser enucleation of benign prostatic hyperplasia in patients with prostates more than 80 cm3.