MP04-16: Thulium YAG vs Thulium Fiber Laser Enucleation of the Prostate (ThuLEP vs TFLEP): a Multi-institution Trial to Compare Intra and Early Postoperative Outcomes.

Matteo Maltagliati, Lorenzo Berti, Busto Arsizio, Italy, Salvatore Micali, Modena, Italy, Umberto Besana, Carlo Buizza, Busto Arsizio, Italy, Bernardo Rocco, Maria Chiara Sighinolfi, Milano, Italy, Andrea Pacchetti, Genova, Italy, Jean Baptiste Roche, Bordeaux, France, Giorgio Bozzini*, Como, Italy

Introduction: To compare clinical intra and early postoperative outcomes between Thulium laser Enucleation of the Prostate (ThuLEP) and Thulium Fiber Laser Enucleation of the Prostate (TFLEP) in the treatment of benign prostatic hyperplasia (BPH).

Methods: 240 patients suffering from lower urinary tract symptoms due to BPH were consecutively enrolled and randomized to either BPH to ThuLEP (n = 117) or TFLEP (n=123). Patients were evaluated preoperatively using the International Prostate Symptom Score (IPSS), Quality of Life score (QoL), maximum flow rate (Qmax), and postvoid residual urine volume (PVR). Preoperative prostate volume, PSA and haemoglobin were also recorded. All the patients were evaluated postoperatively with regards to blood loss, catheterization time, irrigation volume, hospital stay and operative time. 3 months after surgery micturition improvement was evaluated using the IPSS, Qmax and PVR.

Results: No significant differences were found between the patients in the two study arms. Compared with TFLEP, ThuLEP determined a shorter operative time (63.69 ± 41.44 vs 79.66 ± 48.70 minutes, p=0.045). No significant differences were found between ThuLEP and TFLEP in terms of haemoglobin decrease (0.45 vs 0.47 g/dl, p=0.32), catheterization time (1.9 vs 2.1 days, p=0.37), irrigation volume (29.4 vs 32.8 l, p=0.43), and hospital stay (2.2 vs 2.6 days, p=0.22). During the 3 months of follow-up, the procedures did not demonstrate significant differences in Qmax, IPSS, PVR, and QoL.

Conclusions: ThuLEP and TFLEP both relieve lower urinary tract symptoms equally, with high efficacy and safety. ThuLEP was statistically superior to TFLEP in terms of duration of the procedure. Catheterization time, irrigation volume, hospital stay and operative time were comparable.

Source of Funding: None