High-power holmium laser versus thulium fiber laser for endoscopic enucleation of the prostate in patients with glands larger than 80 ml: Results from the Prostate Endoscopic EnucLeation study group

• Published in: Prostate international 2024-03, Vol.12 (1), p.40-45
• Main Authors: Lim, Ee Jean, Castellani, Daniele, Somani, Bhaskar K., Gökce, Mehmet I., Fong, Khi Yung, Sancha, Fernando G., Herrmann, Thomas R.W., Biligere, Sarvajit, Tursunkulov, Azimdjon N., Dellabella, Marco, Sofer, Mario, Enikeev, Dmitry, Petov, Vladislav, Gadzhiev, Nariman, Elterman, Dean, Mahajan, Abhay, Socarras, Moises R., Yunusov, Dilmurod S., Nasirov, Furkat, Teoh, Jeremy Y.C., Gauhar, Vineet
• Format: Article
• Language: English
• Subjects: Endoscopic enucleation of the prostate; Laser therapy; Postoperative complications; Prostatic hyperplasia; Urinary incontinence
• ISSN: 2287-8882; 2287-903X
• DOI: 10.1016/j.prnil.2023.12.001

Endoscopic enucleation of the prostate (EEP) has gained acceptance as an equitable alternative to transurethral resection of the prostate for benign prostate hyperplasia (BPH). Our primary aim is to compare peri-operative outcomes of EEP using thulium fiber laser (TFL) against high-power holmium laser (HPHL) in hands of experienced surgeons for large prostates (≥80 ml in volume). Secondary outcomes were assess complications within 1 year of follow up. We retrospectively reviewed patients with benign prostatic hyperplasia who underwent EEP with TFL or HPHL in 13 centers (January 2019-January 2023). Patients with prostate volume ≥80 ml were included, while those with concomitant prostate cancer, previous prostate/urethral surgery, and pelvic radiotherapy were excluded. Of 1,929 included patients, HPHL was utilized in 1,459 and TFL in 470. After propensity score matching (PSM) for baseline characteristics, 247 patients from each group were analyzed. Overall operative time (90 [70, 120] vs. 52.5 [39, 93] min, P