Thulium laser enucleation of the prostate plus thulium fiber laser therapy for benign prostatic hyperplasia combined with bladder stones

Abstract

Introduction: Population aging is associated with increased incidence of benign prostatic hyperplasia (BPH), which may be complicated by bladder stones (BSs). The conditions are successfully treated with transurethral enucleation of the prostate (TUEP) plus bladder lithotomy. However, open surgery is associated with higher blood loss, larger incisions, prolonged operative time, and may impede patient recovery. Aim: This work explored the feasibility, safety, and efficacy of using thulium laser enucleation of the prostate (ThuLEP) and thulium fiber laser (TFL) on a single-energy platform to treat BPH combined with BS. Materials and methods: Thirty-one patients with BPH complicated by BSs who underwent ThuLEP+TFL at our institution between October 2020 and September 2022 were included in the observation group, while 31 patients undergoing TUEP plus bladder lithotomy during the same period constituted the control group. Data collection involved assessing differences in the International Prostate Symptom Score (IPSS), hemoglobin (Hb) levels, maximum urinary flow rate (Qmax), and quality of life (QoL) before and after surgery, along with follow-up results. Results: The patients in the observation group exhibited lower surgery duration, smaller postoperative decrease in Hb levels, shorter duration of postoperative indwelling catheterization, and proportion of American Society of Anesthesiologists (ASA) II patients, with a higher proportion of ASA I patients than the individuals in the control group (P 0.05); however, the postoperative length of hospital stay was shorter in the observation group (P <⁠0.05), with a higher incidence of complications in the control (P <⁠0.05). Conclusions: In summary, ThuLEP+TFL surgery was safe and feasible in treating BPH+BS, relieving the symptoms, and improving QoL.

Keywords

• benign prostatic hyperplasia
• bladder stone
• thulium fiber laser
• thulium laser enucleation of the prostate