To compare intra and early postoperative outcomes between pulsed-wave and continuous-wave Thulium Fiber Laser Enucleation of the Prostate (PW-ThuFLEP vs CW-ThuFLEP) for the treatment of benign prostatic hyperplasia (BPH).
238 patients with lower urinary tract symptoms (LUTS) due to BPH underwent PW-ThuFLEP (118 patients) vs. CW-ThuFLEP (120 patients). Preoperative prostate volume, adenoma volume, PSA and haemoglobin values were recorded. International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-void residual volume (PVR) and International Index of Erectile Function-5 score (IIEF-5) were assessed. Operative time, enucleation time, enucleation efficiency, catheterization time, irrigation volume, hospital stay, haemoglobin drop and postoperative complications were recorded. Micturition improvements and sexual outcomes were evaluated 3 months after surgery.
CW-ThuFLEP showed shorter operative time (61.5 vs 67.4 min, p=0.04). Enucleation time (50.2 vs 53.3 min, p=0.12), enucleation efficiency (0.8 vs 0.7 g/min, p=0.38), catheterization time (2.2 vs 2.1 days, p=0.29), irrigation volume (32.9 vs 32.8 litres, p=0.71), hospital stay (2.8 vs 2.6 days, p=0.29) and haemoglobin drop (0.38 vs 0.39 g/dL, p=0.53) were comparable. No significant difference in complication rate was observed. At 3-month follow-up, the procedures did not show any significant difference in IPSS, Qmax, PVR, IIEF-5 and PSA value.
PW-ThuFLEP and CW-ThuFLEP both relieve LUTS equally, with high efficacy and safety. Operative time was significantly shorter with CW-ThuFLEP, but with a small difference with low clinical impact. Enucleation time, enucleation efficiency, catheterization time, irrigation volume, hospital stay, haemoglobin and PSA drop, complication rate and sexual outcomes showed no differences.
Urology. 2023 May 29 [Epub ahead of print]
D Perri, F Mazzoleni, U Besana, A Pacchetti, E Morini, L Berti, M Calandriello, A L Pastore, J Romero-Otero, F Bruyere, M C Sighinolfi, B Rocco, S Micali, A S Gozen, E Liatsikos, J B Roche, G Bozzini
Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy. Electronic address: ., Department of Urology, Sant'Anna Hospital, San Fermo della Battaglia, Italy., Department of Urology, ASST Valle Olona, Busto Arsizio Hospital, Busto Arsizio, Italy., Department of Urology, Sapienza University of Rome, Latina., Department of Urology, Hospital Universitario HM Montepríncipe, Madrid, Spain., Department of Urology, CHRU Bretonneau, Tours, France., Department of Urology, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy., Department of Urology, Modena and Reggio Emilia University, Modena, Italy., Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany., Department of Urology, University of Patras, Patras, Greece., Department of Urology, Clinique Saint Augustin, Bordeaux, France.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37257589