Thulium laser enucleation versus thulium laser resection for the treatment of benign prostatic hyperplasia

This study aimed to compare the use of thulium laser enucleation (TLE) versus thulium laser resection (TLR) of the prostate in patients with benign prostatic hyperplasia with small prostates (less than 30 grams). This study found that there were no significant differences between the two procedures for these patients.

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. BPH can impede the flow of urine. This leads to lower urinary tract symptoms (LUTS) such as dribbling of urine and a feeling of incomplete bladder emptying. Thulium laser enucleation (TLE) and thulium laser resection (TLR) can be used to treat BPH. These procedures use a laser to remove prostate tissue that is blocking urine flow. Resection is the removal of prostate tissue. Enucleation is the removal of a mass without cutting into it. It is unclear which technique is better for patients with BPH.

This study included 115 patients with BPH. 48.7% of patients underwent a TLE. The rest had a TLR. All patients were evaluated before surgery and at 1, 3, 6, and 12 months after surgery. Patients were given questionnaires to evaluate their quality of life and the presence of LUTS.

12 months after the procedure, all patients had improvements in quality of life and LUTS. There were no differences in surgical time and length of stay in the hospital between the two procedures.

There were more patients in the TLR group who developed bladder neck contracture (BNC) than in the TLE group (13.6% vs. 1.8%). BNC is the formation of scar tissue where the bladder outlet and prostate meet. Other side effects from the procedures such as urinating blood or urinary tract infections were similar between the two groups. 

This study found that thulium laser enucleation and thulium laser resection had similar safety and effectiveness for patients with BPH and a prostate smaller than 30 grams.

This study included a rather small group of patients. Larger studies are needed to confirm these findings.