Comparison of low- and high-power thulium laser enucleation for benign prostatic hyperplasia with prostates over 80 g

A recent study demonstrated that low-power YAG VapoEnucleation (ThuVEP) is safe, feasible, and effective, showing results similar to high-power ThuVEP in managing benign prostatic obstruction (BPO). The results of this study were published in the World Journal of Urology.
An analysis was carried out on 80 patients with symptomatic BPO and prostatic enlargement exceeding 80 ml. The patients were randomly split into two groups, each consisting of 40 patients. Group A underwent treatment with low-power ThuVEP, while Group B received high-power ThuVEP. Preoperative and early postoperative evaluations were conducted for all patients, with a follow-up analysis of 12 months. Complications were recorded and categorized based on the modified Clavien classification system.
The average age of patients at the time of surgery was 68 (± 6.1) years. The mean prostate volume was 112 (± 20.1) cc. The groups exhibited no significant variations (p value = 0.457). The average operative time for Group A was 88.4 ± 11.79 minutes, and for Group B it was 93.4 ± 16.34 minutes. Group A had a mean enucleation time of 59.68 ± 7.24 minutes, whereas Group B had a mean enucleation time of 63.13 ± 10.75 minutes. Quality of life (QoL), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), prostate volume, and postvoiding residual urine (PVR) all showed significant improvement after treatment and were not significantly different between those treated with different energies. Complications were rare and showed no variation between the two groups.
The above study indicates that low-power ThuVEP is safe, feasible, and effective, demonstrating outcomes comparable with high-power ThuVEP in the management of BPO.