Learning curve of ThuLEP (Thulium laser enucleation of the prostate): Single-centre experience on initial consecutive 60 patients.

Abstract

Benign prostatic hyperplasia (BPH) is a common problem among elderly men. Recently, laser prostate enucleations have gained popularity with successful results; however, it requires steep learning curves. The initial 60 cases of ThuLEP performed at our centre were retrospectively enrolled. A 200W CyberTM Thulium laser (Quanta System, Italy) with 550µm fibre was used, and a single surgeon highly experienced with transurethral resection performed all procedures. Patients were divided into three consecutive groups. Preoperative variables such as prostate volume, prostate-specific antigen and haemoglobin levels, International Prostate Symptom Score (IPSS), International Index of Erectile Function scores and uroflowmetry parameters were all noted. The enucleated tissue weight, enucleation and morcellation times with efficiencies, hospitalization and catheterization times were calculated. Perioperative complications were also observed. The postoperative 6th month uroflowmetry parameters were evaluated and compared with prior ones. Morcellation and enucleation efficiencies, hospitalization and catheterization times, postoperative IPSS were significantly different between the groups. Complications were also compared between the groups, and only short-term perioperative complications were encountered. We aimed to evaluate initial cases of ThuLEP to provide information for beginners with management of early term possible complications. The learning curve for ThuLEP could be handled after exceeding 20 initial cases.