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Thulium laser enucleation versus thulium laser resection of the prostate for prevention of bladder neck contracture in a small prostate: a prospective randomized trial

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Abstract

Purpose

To compare the safety and efficacy of thulium laser enucleation of the prostate (ThuLEP) versus thulium laser resection of the prostate (TmLRP) in small prostates (≤ 30 g) and to test the validity of ThuLEP for bladder neck contracture (BNC).

Methods

A total of 115 patients with benign prostatic hyperplasia (BPH) (prostate size ≤ 30 g) were randomly assigned to ThuLEP (n = 56) or TmLRP (n = 59). All patients were evaluated preoperatively and at 1, 3, 6, and 12 months after surgery. Baseline characteristics of the patients, perioperative data, postoperative outcomes and complications were assessed.

Results

Comparisons of the baseline and perioperative data demonstrated no significant differences between the ThuLEP and TmLRP groups. Significant improvement was noted in the International Prostate Symptom Score, quality of life, maximal urinary flow rate (Qmax) and post-void residual volume (PVR) in both groups at the 12-month follow-up, and assessment showed no differences in these parameters between the two groups. The TmLRP group showed a significantly higher rate (13.6%) of BNC than the ThuLEP group (1.8%; P = 0.045). There were no significant differences in other complications between the two groups (P > 0.05).

Conclusions

ThuLEP and TmLRP are both safe and efficient procedures for the treatment of patients with small prostate volume, while ThuLEP can significantly reduce the risk of BNC in patients with a small prostate because the procedure enucleates adenomas without thermal damage to the bladder neck.

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Acknowledgements

This work was supported by Grants from the National Nature Science Foundation of China (No. 81570682).

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Authors and Affiliations

  1. Department of Urology, Shanghai First People’s Hospital, Nanjing Medical University, No. 100, Haining Road, Shanghai, 200080, China

    Qian Sun

  2. Department of Urology, Shanghai First People’s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 100, Haining Road, Shanghai, 200080, China

    Wenhuan Guo, Di Cui, Xiaohai Wang, Yuan Ruan, Fujun Zhao, Shujie Xia, Bangmin Han & Yifeng Jing

Authors
  1. Qian Sun
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  2. Wenhuan Guo
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  3. Di Cui
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  4. Xiaohai Wang
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  5. Yuan Ruan
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  6. Fujun Zhao
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  7. Shujie Xia
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  8. Bangmin Han
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Contributions

QS and WG: project development, data collection or management, data analysis, manuscript writing/editing. DC and XW: data analysis. FZ, YR and BH: data collection or management. BH, SX and YJ: project development.

Corresponding authors

Correspondence to Bangmin Han or Yifeng Jing.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All patients gave written informed consent. Approval for the study was granted by the Ethics Committee of our hospital prior to recruitment. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

Qian Sun and Wenhuan Guo are first authors.

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Sun, Q., Guo, W., Cui, D. et al. Thulium laser enucleation versus thulium laser resection of the prostate for prevention of bladder neck contracture in a small prostate: a prospective randomized trial. World J Urol 37, 853–859 (2019). https://doi.org/10.1007/s00345-018-2463-8

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  • DOI: https://doi.org/10.1007/s00345-018-2463-8

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