Thulium Laser Enucleation of The Prostate for Treatment of Benign Prostatic Hyperplasia: A Single Center Experience

Background: Benign prostatic hyperplasia (BPH) is a prevalent medical condition in older men that leads to symptoms affecting the lower urinary system (LUTS). Thulium Laser Enucleation of The Prostate (THULEP) seems to be a promising procedure for treatment of BPH with minimal side effects. Objective: To evaluate the outcomes of THULEP in patients with benign prostatic hyperplasia. Patients and methods: A prospective non-controlled study included 30 participants who have failed medical therapy to LUTS attributable to BPH, and underwent THULEP. The primary outcome was International prostate symptom scores (IPSS) score at 6 months. Other outcomes included operative time, intraoperative complications, length of hospital stay, changes in the maximum flow rate, post voiding residual (PVR), prostate-specific antigen (PSA) and continence status. Results: The mean (range) prostate size was 72.3 (40-124) ml, the mean operative duration was 86.40 (48-123) min and the mean enucleation time 73.33 (40-105) min. The improvements in IPSS, Qmax, PVR and PSA were significant (P < 0.001), with mean values before and after THULEP (IPSS from 25 to 2.5, Qmax from 10 ml/sec to 18.1 ml/sec, PVR from 92.5 to 13 ml, PSA from 3 to 1.05, respectively). Of the 30 patients, 20 (66.6%) were catheter-free on the first day after THULEP; the mean hospital stay was 2.63 days. Conclusion: The BPH can be completely removed with ThuLEP. The methods combine high effectiveness with negligible negative effects.