Articles

Benign Prostatic Obstruction

Thulium Laser versus Standard Transurethral Resection of the Prostate: A Randomized Prospective Trial

By: Shu-Jie Xialowast , Jian Zhuo, Xiao-Wen Sun, Bang-Min Han, Yi Shao and Yi-Nan Zhang

European Urology, Volume 53 Issue 1, February 2008, Pages 382-390

Published online: 01 February 2008

Keywords: Benign prostatic hyperplasia, Prostatectomy, Laser surgery, Thulium, Tangerine technique

Abstract Full Text Full Text PDF (1,3 MB)

Abstract

Objective

Thulium laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. To our knowledge we report the first prospective, randomized study comparing TmLRP-TT and standard TURP for symptomatic BPH.

Methods

From November 2004 to December 2005, 100 consecutive BPH patients were randomized for surgical treatment with TmLRP-TT (n=52) or TURP (n=48). All patients were preoperatively assessed with subjective symptoms score, International Index of Erectile Function questionnaire, and complete urodynamic evaluation. Preoperative and perioperative parameters at 1-, 6-, and 12-mo follow-up were also evaluated. All complications were recorded.

Results

TmLRP-TT was significantly superior to TURP in terms of catheterization time (45.7±25.8h vs. 87.4±33.8h, p<0.0001), hospital stay (115.1±25.5h vs. 161.1±33.8h, p<0.0001), and drop in hemoglobin (0.92±0.82g/dl vs. 1.46±0.65g/dl, p<0.001), whereas it required equivalent time to perform (46.3±16.2 vs. 50.4±20.7min, p>0.05). TmLRP-TT and TURP resulted in a significant improvement from baseline in terms of subjective symptoms scoring and urodynamic finding, but no significant difference was found between the two groups. Late complications were also comparable.

Conclusions

TmLRP-TT is an almost bloodless procedure with high efficacy and little perioperative morbidity. TmLRP-TT is superior to TURP in safety and is as efficacious as TURP in 1-yr follow-up. It is a promising technology in the clinical practice field.

Take Home Message

Thulium laser resection of the prostate seems to be as effective as and safer than standard transurethral resection of the prostate.

Keywords: Benign prostatic hyperplasia, Prostatectomy, Laser surgery, Thulium, Tangerine technique.

Footnotes

Department of Urology, First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, China

lowast Corresponding author. Department of Urology, First People's Hospital Affiliated to Shanghai Jiaotong University, No. 85, Wujin Road, Shanghai 200080, China. Tel. +86 21 63250686.

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