Comparing thulium laser enucleation to bipolar resection to treat benign prostatic hyperplasia

This study looked at functional outcomes of transurethral thulium laser enucleation (THU) versus bipolar transurethral resection of the prostate (TURP) for benign prostate hyperplasia (BPH) over 12-months. The authors found that THU may have better effects than TURP.

BPH is the non-cancerous increase in the size of the prostate gland. BPH can cause lower urinary tract symptoms (LUTS) such as frequent urination, trouble starting to urinate, and weak stream while urinating. Other symptoms include being unable to pass urine, or loss of bladder control. LUTS/BPH can lead to problems relating to the quality of life and mental health issues. Sexual function can also be negatively impacted. 

THU is the use of a laser to evaporate excess prostate tissue through the urethra (the tube that passes urine out from the bladder). TURP is a standard surgery that removes the excess prostate tissue through the urethra. TURP was the standard of care for BPH. However, it is commonly associated with side effects such as erectile dysfunction. Newer minimally invasive procedures such as THU may be associated with better functional outcomes, but more comparisons are needed.

There were 140 patients with BPH involved in this study. 70 patients underwent THU and 70 patients underwent TURP. Follow-up was on average 12 months. 

Both groups had significant improvements in urinary symptoms at 12 months. Improvements occurred later in the TURP group compared to the THU group. Both groups had sexual function problems after 1 month from the procedure. However, sexual function scores recovered after 3 months in the THU group, while in the TURP group did not have sexual function recovery after 12 months.  

No significant surgical complications were seen in either group. 

The authors concluded that THU may give better functional outcomes, including sexual function compared to TURP for the treatment of BPH. 

This study had a small number of participants and a short follow-up period. It was also done in one hospital and one surgeon did all the procedures. The results may not apply to patients treated elsewhere. Further studies are needed.