AUA 2017: Thulium Laser Vaporesection of the Prostate and Bipolar Transurethral Resection of the Prostate in Patients With Benign Prostatic Hyperplasia – Single Center Prospective Randomized Study

Boston, MA ( Benign prostatic hyperplasia (BPH), where the prostate glad is enlarged, has been commonly treated using laser surgery such as the transurethral resection. More recently, the thulium laser was in-troduced as another option. This study aims to compare the safety and effectiveness of the thulium laser vaporesections of the prostate (ThuVaRP) compared to the bipolar transurethral resection of the prostate (TURP).

There were a total of 86 patients in this study. They were ran-domized into two groups: 43 patients who underwent ThuVaRP and 43 patients who underwent bipolar TURP. Those who were included had a Qmax of < 15mL/s, repeated urinary retention, and an IPSS >7. Pre-operative and post-operative data was collected. IPSS, TRUS, PSA and uroflowmetry with PVR were reassessed 1 month after sur-gery to compare numbers with the pre-operative data.

An analytical comparison between both groups was made for operation time, volume of resected tissue, remaining volume of the prostate, postoperative hemoglobin level, period of uretheral catheter-ization, days of hospitalization, pre-operative and post-operative data. Unpaired student t-test, paired student t-test, and chi-square tests were used to analyze findings.

It was found that the mean operation time for the ThuVaRP group (93.6±44.4 minutes) compared to the TURP group (76.7±32.0 minutes) was significantly longer (p<0.001). The authors suggest that TURP had a shorter mean operation time due to surgeon experience over the years as it has been the standard surgery used to treat BPH.
Although operation time was significantly longer in ThuVaRP, catheterization time and length of hospital stay were significantly shorter in the ThuVaRP group compared to TURP. ThuVaRP met functional and safety outcomes but not efficacy expectations. Tempo-rary incontinence occurred more frequently in the ThuVaRP group. In conclusion, ThuVaRP has shown results equivalent or superior to those of TURP in terms of effectiveness and safety.

Presented By: Prarthan Joshib

Authors: Prarthan Joshi, Puvvada Sandeep, Prasad Mylarappa, Ramesh Desigowda, Arvind Nayak, Kuldeep Aggarwal

Affiliation: Ramaiah Medical College, Bangalore, India

Written By: Kheira Bettir, University of Irvine, California for

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA