Initial experience with superpulsed thulium laser in prostate enucleation: Prospective randomized multicenter comparative study between HoLEP and ThuLEP in terms of efficacy and safety

You have accessJournal of UrologyCME1 Apr 2023MP59-02 INITIAL EXPERIENCE WITH SUPERPULSED THULIUM LASER IN PROSTATE ENUCLEATION: PROSPECTIVE RANDOMIZED MULTICENTER COMPARATIVE STUDY BETWEEN HOLEP AND THULEP IN TERMS OF EFFICACY AND SAFETY Javier Romero Otero, Raquel Sopeña Sutil, Borja García Gómez, Alfredo Rodriguez Antolin, Juan Justo Quintas, Ricardo Brime Menéndez, Javier Amalio Feltes Ochoa, David Saenz Calzada, Laura Avilleira García, Elena Peña Vallejo, Cristina Calzas Montalvo, Diana María Vallejo Arzayus, and Camila Martinez Otero Javier Romero OteroJavier Romero Otero More articles by this author , Raquel Sopeña SutilRaquel Sopeña Sutil More articles by this author , Borja García GómezBorja García Gómez More articles by this author , Alfredo Rodriguez AntolinAlfredo Rodriguez Antolin More articles by this author , Juan Justo QuintasJuan Justo Quintas More articles by this author , Ricardo Brime MenéndezRicardo Brime Menéndez More articles by this author , Javier Amalio Feltes OchoaJavier Amalio Feltes Ochoa More articles by this author , David Saenz CalzadaDavid Saenz Calzada More articles by this author , Laura Avilleira GarcíaLaura Avilleira García More articles by this author , Elena Peña VallejoElena Peña Vallejo More articles by this author , Cristina Calzas MontalvoCristina Calzas Montalvo More articles by this author , Diana María Vallejo ArzayusDiana María Vallejo Arzayus More articles by this author , and Camila Martinez OteroCamila Martinez Otero More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003312.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is considered as the new “gold standard” to treat surgically BPH. Other types of lasers have been employed to enucleate, but with worse results or less evidence. The new Superpulsed Thulium laser available in the market offers new features that could be a good alternative. Our objective is to compare for the first time in the literature the efficacy and safety of HoLEP 100 Wat versus Superpulsed Thulium laser (TFL) 60 Wat enucleation of the prostate (ThuLEP) in the surgical treatment of BPH. METHODS: Multicenter prospective comparative study of 100 patients randomized 1:1 to be treated with HoLEP vs. superpulsed ThuLEP (TFL), performed by 3 experts surgeons in laser enucleation. Inclusion criteria: patients with moderate/severe symptoms due to BPH. Exclusion criteria: Patients who have received other previous surgical treatment for BPH, urethral stenosis, bladder tumor, or lithiasis. A descriptive analysis of the groups was performed to compare: intraoperative, perioperative, and postoperative results at 3 and 6 months. Statistical significance was established at <0.005. RESULTS: Both arms were similar in preoperative prostate volume, Q max, PSA, bladder catheterization, IPSS, and sexual function (measured by IIEF15). Total surgical time was longer in the HoLEP (mean of 52.90 min) vs. the ThuLEP group (45.55 min), (p=0.075). However, enucleation time was longer with the TFL (26.77 min vs. 23.90 min, p=0.09). No intraoperative complications were recorded. At the perioperative features: no differences between both groups were noted: bladder catheterization: 30.6 vs 32.4 hours, hospitalization 34.2 vs 36.8 hours. Drop in hemoglobin was similar in both groups (no transfusion was required). No differences were noted in: rehospitalization, emergency room, recatheterization, or infection. The resected tissue was 28gr vs 31gr. At three-month follow-up, the improvement in Q max was 14.00 ml/s and 10.75 ml/s for HoLEP and ThuLEP, respectively, but statistical significance was not reached. No differences were found in the IIEF-15 questionnaire and only one patient in each arm reported preserving ejaculatory function. The incontinence rate was slightly higher in the ThuLEP group but was equalized at 6-month follow-up. CONCLUSIONS: In expert hands, the first cases of prostatic enucleation with superpulsed Thulium laser (TFL) are comparable to Holmium laser in terms of functional results and post-surgical complications. Source of Funding: No © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e806 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Javier Romero Otero More articles by this author Raquel Sopeña Sutil More articles by this author Borja García Gómez More articles by this author Alfredo Rodriguez Antolin More articles by this author Juan Justo Quintas More articles by this author Ricardo Brime Menéndez More articles by this author Javier Amalio Feltes Ochoa More articles by this author David Saenz Calzada More articles by this author Laura Avilleira García More articles by this author Elena Peña Vallejo More articles by this author Cristina Calzas Montalvo More articles by this author Diana María Vallejo Arzayus More articles by this author Camila Martinez Otero More articles by this author Expand All Advertisement PDF downloadLoading ...