High-power as good as low-power thulium laser enucleation for relieving bladder outlet obstruction due to BPH: Study

A significant study regarding the treatment of large-volume benign prostatic hyperplasia (BPH) revealed that low-power Thulium:YAG VapoEnucleation (ThuVEP) is just as effective and safe as its high-power counterpart. This finding published in the recent edition of World Journal of Urology could influence future treatment protocols and equipment choices for urological surgeries across the world.

The study focused on a total of 80 patients who suffered from symptomatic benign prostatic obstruction (BPO) with prostate volumes exceeding 80 ml. They were randomly assigned into a group receiving low-power and the other group who received high-power ThuVEP treatment. The data analyzed over a 12-month follow-up period highlighted the perioperative and functional outcomes of these two surgical methods.

The key findings include the mean age of participants at 68 years and an average prostate volume of 112 cc, with no significant initial differences between the two groups. Surgical and enucleation times were slightly shorter in the low-power group, but the differences were not statistically significant. Both groups showed considerable improvements in prostate-related symptoms post-surgery which was measured by metrics like the quality of life (QoL), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax) and post-voiding residual urine (PVR).

Also, both surgical techniques demonstrated low complication rates which were similar across both the groups. This aspect is crucial as it suggests that the lower power setting does not compromise patient safety or the efficacy of the procedure. The findings of this study are pivotal for medical facilities considering the cost-effectiveness and accessibility of surgical equipment. Low-power ThuVEP not only requires less energy but might also lead to a lowered wear and tear on valuable medical instruments by potentially lowering operating costs without sacrificing clinical outcomes.

As the results of this study are critical, this could help the medical community prompt a reevaluation of current surgical standards and practices for treating large-volume BPH. This study adds valuable data to the existing pool of urological research and additionally opens the door for future studies to further refine and optimize the treatment of prostate enlargement for the best possible patient outcomes with consideration of economic factors in healthcare delivery.

Reference:

Abdelaziz, A. Y., Kamal, I., Abdelhakim, M. A., Abdelmohsen, M., Meshref, A., Naser, I., & Morsy, S. (2024). A prospective analysis of thulium laser enucleation in benign prostatic hyperplasia comparing low- and high-power approaches for prostates exceeding 80 g. In World Journal of Urology (Vol. 42, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1007/s00345-024-04901-w