Thulium: Yag laser vapoenucleation of the prostate vs. standard transurethral resection in benign prostatic hyperplasia treatment

Introduction. Thulium:YAG laser has been increasingly used in retrograde transurethral enucleation of the prostate as a new advanced surgical treatment in benign prostatic hyperplasia (BPH). The implementation of Thulium:YAG laser prostatic vapoenucleation (ThuVEP) will allow patients with large BPH, who have traditionally been treated via open adenomectomy or monopolar transurethral resection, to undergo minimally invasive endoscopic treatment by using laser energy. The objective of the study was to provide a comparative assessment of ThuVEP vs. standard transurethral resection (TURP) in the treatment of benign prostatic hyperplasia. Material and methods. The study was conducted on 81 patients with BPH, regarding the appropriate surgical treatment, including ThuVEP (40 patients) and TURP (41 patients), from May to December 2018. All patients were assessed before surgery and 3, 6 and 12 months after surgery. The obtained data were compared retrospectively. Results. ThuVEP has proven its long-expected surgical efficacy. The main urodynamic and ultrasonographic indices at 12 months postoperatively showed no statistically significant difference. Moreover, the incidence rate of surgical complications was lower in the ThuVEP group. Patients from the ThuVEP group did not require further blood transfusions. Conclusions. ThuVEP exhibited major efficacy and maximum efficiency in the treatment of BPH in our study. Thulium:YAG laser used in the surgical treatment of BPH is considered superior compared to the classic TURP endourological technique, as well as promising for clinical practice. Further long-term patients’ follow-up is necessary to assess the durability of the intervention.