Efficacy and Safety of 120‑W Thulium:Yttrium‑Aluminum‑Garnet Vapoenucleation of Prostates Compared with Holmium Laser Enucleation of Prostates for Benign Prostatic Hyperplasia

Background: This study compared the efficacy and safety between 120‑W thulium:yttrium‑aluminum‑garnet (Tm:YAG) vapoenucleation of prostates (ThuVEP) and holmium laser enucleation of prostates (HoLEP) for patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).

Methods: A retrospective analysis of 88 consecutive patients with symptomatic BPH was carried out, who underwent either 120‑W ThuVEP or HoLEP nonrandomly. Patient demographics and peri‑operative and 12‑month follow‑up data were analyzed with the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum flow rate (Qmax), postvoid residual urine volume (PVR), and rates of peri‑operative and late complications.

Results: The patients in each group showed no significant difference in preoperative parameters. Compared with the HoLEP group, patients in the 120‑W ThuVEP group required significantly shorter time for laser enucleation (58.3 ± 12.8 min vs. 70.5 ± 22.3 min, P = 0.003), and resulted in a significant superiority in laser efficiency (resected prostate weight/laser enucleation time) for 120‑W Tm:YAG laser compared to holmium:YAG laser (0.69 ± 0.18 vs. 0.61 ± 0.19, P = 0.048). During 1, 6, and 12 months of follow‑ups, the procedures did not demonstrate a significant difference in IPSS, QoL score, Qmax, or PVR (P > 0.05). Mean peri‑operative decrease of hemoglobin in the HoLEP group was similar to the ThuVEP group (17.1 ± 12.0 g/L vs. 15.2 ± 10.1 g/L, P = 0.415). Early and late incidences of complications were low and did not differ significantly between the two groups of 120‑W ThuVEP and HoLEP patients (P > 0.05).

Conclusions: 120‑W ThuVEP and HoLEP are potent, safe and efficient modalities of minimally invasive surgeries for patients with LUTS due to BPH. Compared with HoLEP, 120‑W ThuVEP offers advantages of reduction of laser enucleation time and improvement of laser efficiency.