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A prospective, randomized trial comparing thulium vapoenucleation with holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic obstruction: perioperative safety and efficacy

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World Journal of Urology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 04 December 2017

Abstract

Introduction and objectives

To compare the perioperative outcomes of thulium vapoenucleation of the prostate (ThuVEP) with holmium laser enucleation of the prostate (HoLEP) for patients with symptomatic benign prostatic obstruction (BPO).

Methods

Forty-eight and 46 patients were prospectively randomized to ThuVEP and HoLEP. All patients were assessed preoperatively and 4-week postoperatively. The complications were noted and classified according to the modified Clavien classification system. Patient data were expressed as median (interquartile range) or numbers (%).

Results

Median age at surgery was 73 (67–76) years and median prostate volume was 80 (46.75–100) cc and not different between the groups (p = 0.207). The median operative time was 60 (41–79) minutes without significant differences between both groups (p = 0.275). There were no significant differences between the groups regarding catheterization time [2 (2–2) days, p = 0.966] and postoperative stay [2 (2–3) days, p = 0.80]). Clavien 1 (13.8%), Clavien 2 (3.2%), Clavien 3a (2.1%), and Clavien 3b (4.3%) complications occurred without significant differences between the groups. However, the occurrence of acute postoperative urinary retention was higher after HoLEP compared to ThuVEP (15.2 vs. 2.1%, p ≤ 0.022). At 1-month follow-up, peak urinary flow rates (10.7 vs. 22 ml/s), post-void residual volumes (100 vs. 20 ml), International Prostate Symptom Score (20 vs. 10) and Quality of Life (4 vs. 3) had improved significantly (p ≤ 0.005) without significant differences between the groups.

Conclusions

ThuVEP and HoLEP are safe and effective procedures for the treatment of symptomatic BPO. Both procedures give equivalent and satisfactory immediate micturition improvement with low perioperative morbidity.

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Author information

Authors and Affiliations

  1. Department of Urology, Asklepios Hospital Barmbek, Rübenkamp 220, 22291, Hamburg, Germany

    Christopher Netsch, B. Becker, C. Tiburtius, C. Moritz, A. Venneri Becci & A. J. Gross

  2. Department of Urology, MHH Medical School of Hannover, Hannover, Germany

    T. R. W. Herrmann

Authors
  1. Christopher Netsch
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  2. B. Becker
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  3. C. Tiburtius
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  4. C. Moritz
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  5. A. Venneri Becci
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  6. T. R. W. Herrmann
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  7. A. J. Gross
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Contributions

CN: Project development, data collection, manuscript writing, data analysis and interpretation. BB: Data collection and manuscript writing. CT: Data collection. CM: Data collection. AVB: Data collection. TRWH: Manuscript writing, data analysis and interpretation. AJG: Project development, manuscript writing, data analysis and interpretation.

Corresponding author

Correspondence to Christopher Netsch.

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All patients were treated after obtaining informed consent, following institutional review board approval.

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The authors have nothing to disclose.

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Netsch, C., Becker, B., Tiburtius, C. et al. A prospective, randomized trial comparing thulium vapoenucleation with holmium laser enucleation of the prostate for the treatment of symptomatic benign prostatic obstruction: perioperative safety and efficacy. World J Urol 35, 1913–1921 (2017). https://doi.org/10.1007/s00345-017-2071-z

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  • DOI: https://doi.org/10.1007/s00345-017-2071-z

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