Thulium laser enucleation versus transurethral resection of the prostate in saline in the management of benign prostatic hyperplasia: experience in a developing country

El Moazen, Mohamed I.; Selim, Bassim N.; El Shorbagy, Amr F.; Shoeb, Mohamed S.; El Shorbagy, Ahmed A.

doi:10.4103/ejs.ejs_200_21

Thulium laser enucleation versus transurethral resection of the prostate in saline in the management of benign prostatic hyperplasia: experience in a developing country

Authors

Abstract

Introduction
Transurethral resection of the prostate in saline (TURis) was introduced as an alternative to monopolar resection to reduce its complications. Among all the emerging lasers, thulium has gained high acceptance and become an alternative therapeutic option in prostate enucleation (ThuLEP). Literature on ThuLEP is still limited; to our best knowledge, cost-effectiveness between both techniques in developing countries had not been estimated before.
Patients and methods
This is a prospective, randomized, comparative study comparing two different techniques for treating benign prostatic hyperplasia. Sample size was 40 cases, which were randomly assigned into two groups. Preoperative, operative, and early postoperative data were collected and compared. Patients were followed up for 1 month for evaluating postoperative effectiveness. Running cost was also evaluated for both techniques.
Results
We evaluated 37 patients who completed follow-up and their data were analyzed. ThuLEP was associated with less hemoglobin drop (1.14±0.95) compared with 2.54±1.21 for TURis. Also, the amount of irrigation volume needed was less for ThuLEP. Both show high statistical significance. Weight of the extracted tissue, hospital stay, and catheterization time were statistically significantly better with ThuLEP. Results after 1 month as regards postvoid residual urine, International Prostate Symptom Score, and Qmax improvement were indifferent confirming equal efficacy of both techniques. In the cost analysis, ThuLEP was more cost-effective than TURis.
Conclusion
Both ThuLEP and TURis were safe and effective in the surgical management of benign prostatic hyperplasia. The ThuLEP technique was associated with less hemoglobin drop, less hospital stay, and catheterization time and was more cost-effective than TURis.

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