A Prospective Comparative Study Evaluating the Safety and Efficacy of Transurethral Thulium Fiber Laser, Holmium Laser and Bipolar Enucleation of Large Sized Prostate
Tanta University
90 participants
Oct 21, 2025
INTERVENTIONAL
Conditions
Summary
This study compares the safety and efficacy of three endoscopic enucleation techniques for large prostates (\>100 mL) in patients with benign prostatic hyperplasia (BPH): Thulium Fiber Laser Enucleation (ThuFLEP), Holmium Laser Enucleation (HoLEP), and Bipolar Enucleation (B-TUEP). Ninety male patients with severe lower urinary tract symptoms (IPSS ≥20, Qmax ≤10 mL/s) who failed medical therapy will be randomized 1:1:1 into three groups of 30. Primary outcomes include IPSS, quality of life score, maximum flow rate (Qmax), and post-void residual at 1, 3, and 6 months postoperatively. Secondary outcomes include operative time, enucleation efficiency, blood loss, catheterization duration, hospital stay, and complication rates assessed by the Clavien-Dindo classification.
Eligibility
Inclusion Criteria6
- Male patients diagnosed with BPH
- Clinical diagnosis of BPH with lower urinary tract symptoms.
- IPSS ≥ 20 (severe symptoms)
- Maximum urinary flow rate (Qmax) ≤ 10 mL/s
- Prostate volume >100 mL (measured by transrectal ultrasound)
- Failed medical therapy and fit for operation
Exclusion Criteria9
- Prostate cancer (current or history).
- Previous prostate surgery
- Previous urethral surgery.
- Neurogenic bladder dysfunction.
- Active urinary tract infection.
- Severe cardiovascular disease (ASA Class IV).
- Previous pelvic radiation.
- Urethral stricture
- Urinary bladder stones.
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Interventions
Anatomical endoscopic enucleation of the prostate performed transurethrally using a Quanta thulium fiber laser at 60 watts with a 550 μm thulium fiber. Enucleated tissue was removed using a morcellator.
Anatomical endoscopic enucleation of the prostate performed transurethrally using a Quanta holmium YAG laser at 150 watts with a 550 μm holmium fiber. Enucleated tissue was removed using a morcellator.
Anatomical endoscopic enucleation of the prostate performed transurethrally using standard bipolar electrical energy. Enucleated tissue was removed using a morcellator.
Locations(1)
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NCT07627178