OBJECTIVE  Both Thulium laser and Holmium laser transurethral enucleation of the prostate (ThuLEP and HoLEP) release the obstructive symptoms effectively due to BPH. The purpose of this study is to compare the clinical outcomes between ThuLEP (70W) and HoLEP (90W) in a prospective randomized trial with 18-months follow-up. 首都医科大学附属北京友谊医院泌尿外科张峰波

METHODS  133 consecutive BPH patients were randomized to either ThuLEP ( n=71) or HoLEP (n=62). Energy setting 70W and 90W for Thulium laser and Homium laser respectively was applied for enucleation procedure. Mushroom technique was used to morcellate the enucleated lobes. The preoperative/postoperative parameters were compared.

RESULTS   ThuLEP had a longer operation time (72.4 min vs 61.5 min, p=.034) but less blood loss than HoLEP (130.0 ml vs 166.6ml, p=.045). Catheterization time was similar. At the 18^th month LUTS indexes were improved significantly in both groups than baseline values: IPSS decreased to 5.2 in ThuLEP and 6.2 in HoLEP; QoLs and Qmax are similar between the two groups (1.3 vs 1.2 and 23.4 ml/s vs 24.2 ml/s) and PVR volume decreased by 82.50% and 81.73%, respectively. The mean PSA decrease after HoLEP and ThuLEP were 30.43% and 43.36% respectively. No urethral or bladder neck stricture were found in both groups.

CONCLUSIONS Both ThuLEP (70W) and HoLEP (90W) release LUTS equally with high efficacy and safety. ThuLEP is statistically superior to HoLEP in blood loss and inferior to HoLEP in operation time although the differences are clinically negligible. Mushroom technique could be adequate without additional mechanical tissue morcellators.

作者：张峰波，邵强等

作者单位：首都医科大学附属北京友谊医院 泌尿外科

全文请参见：UROLOGY 79（4）: 869 – 874, 2012. © 2012 Elsevier Inc