Abstract
OBJECTIVE: To compare the outcomes of laser enucleation techniques by evaluating the postoperative data of patients with benign prostate obstruction (BPO) undergoing ThuFLEP and HoLEP. METHODS: This retrospective study included men > 50 years with LUTS due to BPO who underwent HoLEP or ThuFLEP by a single experienced surgeon between January 2023 and January 2024. Patients were also stratified into subgroups according to prostate size (< 80 g vs. ≥ 80 g). The primary outcome was to compare success rate, operative duration, and efficiency of HoLEP and ThuFLEP; secondary outcomes included safety profile, catheter removal time, and long-term complications (stress urinary incontinence and stricture). RESULTS: A total of 163 patients (HoLEP: n = 94, ThuFLEP: n = 69) were included. Median operation time was longer in ThuFLEP (100 vs. 90 min, p = 0.001). Enucleation ratio, surgical efficiency, haemoglobin drop, ∆PVR, ∆Qmax, and ∆QoL were similar. IPSS improvement was greater in ThuFLEP (15 vs. 10 points, p = 0.023). In prostates > 80 g, ThuFLEP had longer operation and hospitalization times, but other perioperative and functional outcomes were comparable. Complication rates, catheterization time, and discharge duration were similar in all groups. CONCLUSIONS: Both HoLEP and ThuFLEP are safe and effective for BPH treatment. ThuFLEP shows slightly longer operative time, especially in larger prostates, while functional improvements and complication rates are comparable.