Abstract
Objective
To evaluate whether 2 similar en bloc thulium laser enucleation of the prostate (ThuLEP)
techniques can influence surgical complications and outcomes.
Material
Within 2 institutional databases 164 men who underwent 2 different en bloc ThuLEP
techniques were compared using propensity scores. With the first technique prostatic
lobes were all enucleated en bloc, whereas, with the second the median lobe was enucleated
first and the lateral lobes were enucleated en bloc thereafter. All patients were
evaluated at baseline and 6 months after surgery with PSA, Qmax, and self-administrated
IPSS. Operative data and 30-day postoperative complications were gathered.
Results
Surgical time and 24-hour blood loss were similar between 2 groups (55 vs 55 minutes,
P .97288; −0.9 vs −1.3 g/dL, P .112 respectively). Median hospital stay after surgery was 3 days in both groups
(P .3251). IPSS and Qmax improved equally in both groups (median 3 vs 3, P .941; 19.17 vs 20.63 mL/s, P .8232 respectively). Early complications were mild to moderate (Clavien I 12.2% vs
12.2%; Clavien II 3.6% vs 4.84%; Clavien IIIb 1.2% vs 2.4%).
Conclusion
Our results show that en bloc ThuLEP approaches appear feasible, have similar complications
and outcomes and can be considered surgeon-independent techniques. En bloc ThuLEP
may be proposed even for laser-naïve urologists as an alternative to the original
3-lobe technique.
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Article info
Publication history
Published online: June 10, 2018
Accepted:
May 16,
2018
Received in revised form:
May 14,
2018
Received:
March 14,
2018
Footnotes
Declaration of interest: Giovanni Saredi does surgical tutorship for Quanta System and receives honoraria for his tutorship. Daniele Castellani, Giacomo Maria Pirola, Luca Gasparri, Maria Pia Pavia, Francesca Ambrosini, Lorenzo Berti, Federico Sembenini, and Marco Dellabella have no conflict of interest with any institution or product that could have affected their manuscript.
Financial disclosures: The authors declare that they have no relevant financial interests.
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