Abstract
INTRODUCTION: Thulium laser enucleation of the prostate (ThuLEP) and bipolar transurethral resection of the prostate (bipolar TURP) are established surgical therapy alternatives that have proved effective in treating benign prostatic hyperplasia (BPH). AIM: This study aimed to compare perioperative and functional results obtained in patients with moderate-to-large BPH treated with ThuLEP and bipolar TURP. MATERIALS AND METHODS: This was a retrospective multicenter study of 154 men at a mean (SD) age of 68.4 (7.9) years, who received ThuLEP (n = 78) or bipolar TURP (n = 76) in 2018-2024 in 2 hospitals in Amman, Jordan. The collected data included demographics, comorbidities, perioperative variables, complications, and functional outcomes at 1 and 6 months postoperatively. RESULTS: ThuLEP was associated with greater mean (SD) tissue removal (61.4 [18.2] vs 44.9 [14.6] g; P = 0.001), lower estimated blood loss (120 [65] vs 260 [110] ml; P = 0.001), shorter catheterization time (29.4 [9.8] vs 52.1 [14.3] h; P = 0.001), and shorter hospital stay (1.6 [0.7] vs 3.1 [1.2] d; P <0.001), as compared with TURP. At 6 months, ThuLEP also resulted in a lower mean (SD) International Prostate Symptom Score (6.1 [2.8] vs 8.7 [3.4]; P <0.001), better quality of life score (1.1 [0.6] vs 1.8 [0.8]; P <0.001), and a higher maximum urinary flow rate (22.4 [5.2] vs 17.6 [4.7] ml/s; P <0.001). ThuLEP was an independent predictor of a favorable perioperative outcome (adjusted odds ratio, 2.74; 95% CI, 1.32-5.68; P = 0.006). CONCLUSIONS: ThuLEP is safer and more effective in patients with moderate-to-large volume prostates.