Thulium Laser Vaporesection Versus Transurethral Electrovaporization of the Prostate in High-Risk Patients with Benign Prostatic Hyperplasia

Abstract

The purpose of this study was to compare the safety and efficacy of the thulium laser vaporesection and transurethral electrovaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia. From September 2009 to March 2011, 98 consecutive patients with symptomatic bladder outlet obstruction caused by benign prostatic hyperplasia received either thulium laser vaporesection of the prostate (n=42) or transurethral electrovaporization of the prostate (n=56) at our institution. Functional follow-up included measurement of International Prostate Symptom Score, quality of life score, maximal urinary flow rate, and post-voiding residual urine volume. All complications were recorded. Thulium laser vaporesection of the prostate was slightly superior to transurethral electrovaporization of the prostate in catheterization time (2.1±0.9 vs. 4.5±1.3 days, p<0.0001) and postoperative hospital stay (4.4±1.8 vs. 6.6±2.0 days, p<0.0001). Within the observation period, both groups had a significant improvement from baseline in subjective or objective success rates; however, no significant difference was found between the two groups. Peri- and postoperative complications were fewer in the thulium laser group. Thulium laser vaporesection of the prostate is as effective as transurethral electrovaporization of the prostate in managing high-risk patients, with sufficient tissue ablation and acceptable hemostasis, and has the advantage of less morbidity and shorter catheter time and postoperative hospital stay.