Clinical Efficacy Study of Transurethral Thulium Laser Enucleation of the Prostate and Transurethral Bipolar Plasma Resection of the Prostate in the Treatment of Benign Prostatic Hyperplasia

Abstract

Objective: This study aims to evaluate the clinical efficacy of transurethral thulium laser enucleation of the prostate (ThuLEP) and transurethral bipolar plasma resection of the prostate (B-TURP) in the treatment of male benign prostatic hyperplasia (BPH) through a retrospective study.

Methods: We retrospectively collected the medical records of male patients with BPH who were admitted to our hospital from January 2020 to December 2023. Patients were divided into two groups on the basis of the surgical approach: The ThuLEP group (T group) and the B-TURP group (B group). We compared the operative time, haemoglobin drop, weight of the resected tissue, bladder irrigation time, catheterisation time and hospital stay. The International Prostate Symptom Score (IPSS) and the International Consultation on Incontinence Questionnaire-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) were collected from patients in both groups in the first and third months after surgery. Information on postoperative complications during hospitalisation and at three months in both groups of patients was collected.

Results: A total of 110 patients with BPH were included in this study (T group n = 56; B group n = 54). No statistically significant differences in age, body mass index (BMI), prostate volume and other general medical history data were observed between the two groups (p > 0.05). Moreover, no statistically significant difference was found in postoperative tube placement time and length of hospitalisation between the two groups of patients (p > 0.05). Patients in the T group had longer operative time and bladder irrigation time, greater weight of the resected prostate and greater haemoglobin drop compared with the B group, with statistically significant differences (p < 0.05). The IPSS and ICIQ-MLUTS scores in the first and third months postoperatively were higher in the B group than in the T group, and the IPSS scores in the third month showed a statistically significant difference between the two groups (p < 0.05). The incidence of complications in the T group was lower than in the B group, but the differences were not statistically significant (p > 0.05).

Conclusions: Although the ThuLEP procedure time is longer, patients have faster postoperative recovery, higher haemoglobin levels and better IPSS score performance in the third month. Therefore, ThuLEP may be a better choice than B-TURP for urologists.

Keywords: benign prostatic hyperplasia; laser scalpel; prostate; surgery; transurethral prostatectomy.