Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial.
OBJECTIVE
Thulium laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. To our knowledge we report the first prospective, randomized study comparing TmLRP-TT and standard TURP for symptomatic BPH.


METHODS
From November 2004 to December 2005, 100 consecutive BPH patients were randomized for surgical treatment with TmLRP-TT (n=52) or TURP (n=48). All patients were preoperatively assessed with subjective symptoms score, International Index of Erectile Function questionnaire, and complete urodynamic evaluation. Preoperative and perioperative parameters at 1-, 6-, and 12-mo follow-up were also evaluated. All complications were recorded.


RESULTS
TmLRP-TT was significantly superior to TURP in terms of catheterization time (45.7+/-25.8h vs. 87.4+/-33.8h, p<0.0001), hospital stay (115.1+/-25.5h vs. 161.1+/-33.8h, p<0.0001), and drop in hemoglobin (0.92+/-0.82 g/dl vs. 1.46+/-0.65 g/dl, p<0.001), whereas it required equivalent time to perform (46.3+/-16.2 vs. 50.4+/-20.7 min, p>0.05). TmLRP-TT and TURP resulted in a significant improvement from baseline in terms of subjective symptoms scoring and urodynamic finding, but no significant difference was found between the two groups. Late complications were also comparable.


CONCLUSIONS
TmLRP-TT is an almost bloodless procedure with high efficacy and little perioperative morbidity. TmLRP-TT is superior to TURP in safety and is as efficacious as TURP in 1-yr follow-up. It is a promising technology in the clinical practice field.
Xia
Shu-Jie
SJ
Department of Urology, First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, China. xsj@citiz.net
Zhuo
Jian
J
Sun
Xiao-Wen
XW
Han
Bang-Min
BM
Shao
Yi
Y
Zhang
Yi-Nan
YN
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013932:Thulium; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome
D013932:Thulium