Thulium: YAG Laser Vaporesection Versus Bipolar Transurethral Resection of the Prostate for the Treatment of Benign Prostatic Hyperplasia: A Comparative Study

Introduction: Benign prostatic hyperplasia (BPH) is one of the most common causes of urinary obstruction, which occurs in 50% to 60% of men > 60 years old. Transurethral resection of the prostate (TURP) has been recognized as the gold standard surgical option for treatment of BPH. Over the past decade, different laser systems have been successfully introduced for laser prostatectomy including the Thulium laser.

Methods: From January 2016 to October 2017, we compared 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 large prostates ranged between 60 gm and 90 gm.

Results: A total of 120 patients were randomly divided into two groups and managed by ThuVaRP (58, group 1) or B-TURP (62, group 2) with mean age in ThuVaRP group 66 ± 7 years and 69 ± 7 years in B-TURP group with no significant difference. Compared to the B-TURP group , the ThuVaRP group had a less intra-operative blood loss 91 ± 35 vs 260 ± 143 ml (P=0.0001), longer operative time 117 ± 24 vs 101 ± 29 min (P=0.017), shorter 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.

Conclusion: 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.