Holmium, Thulium, or Bipolar Enucleation for Large Prostate Glands

What is it about?

This study compares the outcome and morbidity of three minimally invasive techniques for treating large symptomatic benign prostatic obstruction (BPO): holmium laser enucleation of the prostate (HoLEP), thulium laser enucleation of the prostate (ThuLEP), and bipolar transurethral enucleation of the prostate (B-TUEP). The study found no significant difference in maximum urinary flow rate (Q max ) between the groups at 6 and 12 months, and no significant difference regarding International Prostate Symptom Score (IPSS), quality of life (QoL) or postvoid residual urine volume (PVR). The median (interquartile range) prostate-specific antigen (PSA) reductions (ng/ml) were similar in the three groups at last follow-up point (4).

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Photo by JJ Ying on Unsplash

Photo by JJ Ying on Unsplash

Why is it important?

This study is important because it is the first non-inferiority randomized controlled trial to compare the outcomes and morbidity of three minimally invasive enucleation techniques for treating large symptomatic benign prostatic obstruction (BPO). The three techniques being compared are Holmium laser enucleation of the prostate (HoLEP), Thulium laser enucleation of the prostate (ThuLEP), and Bipolar transurethral enucleation of the prostate (B-TUEP). The study found that there was no significant difference in the primary outcome of maximum urinary flow rate (Qmax) at 6 and 12 months between the groups. This suggests that these three techniques have similar efficacy and may be considered as viable options for treating large BPO. The study provides objective evidence that endoscopic enucleation of the prostate is a technique rather than energy dependent procedure. Key Takeaways: 1. This study is the first non-inferiority randomized controlled trial to compare the outcomes and morbidity of three minimally invasive enucleation techniques for treating large symptomatic benign prostatic obstruction (BPO). 2. The three techniques being compared are Holmium laser enucleation of the prostate (HoLEP), Thulium laser enucleation of the prostate (ThuLEP), and Bipolar transurethral enucleation of the prostate (B-TUEP). 3. The study found that there was no significant difference in the primary outcome of maximum urinary flow rate (Qmax) at 6 and 12 months between the groups, suggesting that these three techniques have similar efficacy. 4.The study provides objective evidence that endoscopic enucleation of the prostate is a technique rather than energy dependent procedure.

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