Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology

MP11-4 - Thulium:YAG laser vaporesection versus bipolar transurethral resection of the prostate for the treatment of benign prostatic hyperplasia: comparative study

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective : To compare the safety and effectiveness of Thulium:YAG laser vaporesection (ThuVaRP) versus bipolar
transurethral resection of the prostate (B-TURP) for the treatment of patients with symptomatizing large prostates ( > 60 gm); in terms of surgical efficacy and
perioperative morbidity.


Methods : From January 2016 to March 2018, this study was conducted in 189 patients diagnosed with lower urinary tract symptoms due to benign
prostatic hyperplasia (BPH).
The perioperative parameters, therapeutic effects and complications were compared between the two groups before and 3 months after surgery. Preoperative
evaluation included detailed medical history, thorough clinical examination, International Prostate Symptom Score (IPSS), digital rectal examination (DRE),
prostate volume, post-voiding residual urinary volume (PVR), PSA level and maximum flow rate (Qmax). Intraoperative evaluation included operative time,
resected tissue weights, irrigating fluid volume, blood loss, and intraoperative complications. Postoperative evaluation included the mean hemoglobin and
hematocrit differences, catheterization period, hospital stay, postoperative complications and follow up IPSS, PVR and Qmax.


Results : A total of 189 patients were randomly divided into two groups and managed by ThuVaRP (63, group 1) or B-TURP (126, group 2) with mean
age ± SD: ThuVaRP 66 ± 7 and B-TURP 69 ± 7 with no significant difference. There was no significant statistical difference in preoperative variables such as
medical condition, IPSS, prostate volume, PVR, PSA and Qmax between the two groups. There were significant statistical differences in the following parameters
between the two groups (ThuVaRP vs B-TURP [mean ± SD]): calculated intraoperative blood loss 91 ± 35 vs 260 ± 143 ml (P=0.0001), operative time 117 ± 24 vs
101 ± 29 min (P=0.017), catheterization time 2.7 ± 0.5 vs 3.3 ± 0.8 days (P=0.001) and hospital stay 2.5 ± 0.6 vs 3.2 ± 0.4 days (P=0.0001) respectively.
Postoperative hemoglobin, hematocrit drops, hematuria and irrigation time were less in ThuVaRP but with no significant statistical differences. In both groups,
there was no need for blood transfusion. Also, TUR syndrome did not occur in any patient. All patients in both groups showed marked improvement in IPSS,
Qmax, and PVR after 3 months postoperative.


Conclusions : ThuVaRP represents a valuable option for the management of BPH with satisfactory outcomes in terms of safety, blood loss and
acceptable complications, but with longer operative time in comparison to B-TURP.

Mohamed A. Rokba

Urology Department Faculty of Medicine- Menofia University.
Shebin Elkom, Al Minufiyah, Egypt

Mohamed M. Abdallh

Urology Department Faculty of Medicine- Menofia University.
Shebin Elkom, Al Minufiyah, Egypt

Mohamed A. Selim

Urology Department Faculty of Medicine- Menofia University.
Shebin Elkom, Al Minufiyah, Egypt

Alaa M. Elmahdy

Urology Department Faculty of Medicine- Menofia University.
Shebin Elkom, Al Minufiyah, Egypt

Sultan M. Sultan

Urology Department Faculty of Medicine- Menofia University.
Shebin Elkom, Al Minufiyah, Egypt