Surgical techniques compared for ThuLEP for benign prostatic hyperplasia

For patients undergoing Thulium laser enucleation of the prostate (ThuLEP) for benign prostatic hyperplasia (BPH), there are no significant differences in intraoperative and postoperative complications or in functional outcomes at three months for distinct surgical techniques, according to a study published online July 22 in the World Journal of Urology.

Francesco Cantiello, M.D., Ph.D., from the Magna Graecia University of Catanzaro in Italy, and colleagues conducted a retrospective analysis of patients undergoing ThuLEP for BPH between January 2019 and January 2024. Patients undergoing en-bloc, three-lobe, and two-lobe techniques were propensity score-matched; after matching, 213 patients were included in the analysis.

The researchers found that the en-bloc and two-lobe groups had significantly shorter enucleation, laser enucleation, morcellation, and operative times and total energy delivered compared with the three-lobe group in an intraoperative analysis. In terms of intraoperative and postoperative complications, there were no significant differences among the groups. At the three-month follow-up, no significant differences were seen among the groups in functional outcomes.

"While the en-bloc and two-lobe techniques may offer efficiency benefits and could be considered safe alternatives in ThuLEP procedures, the reduction in laser enucleation time and energy delivered did not necessarily translate into improvements in postoperative storage symptoms or other functional outcomes," the authors write.

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