Thulium laser enucleation of the prostate plus thulium fiber laser therapy for benign prostatic hyperplasia combined with bladder stones

INTRODUCTION Population aging is associated with increased incidence of benign prostatic hyperplasia (BPH), which may be complicated by bladder stones (BSs). The conditions are successfully treated with transurethral enucleation of the prostate (TUEP) plus bladder lithotomy. However, open surgery is associ- ated with higher blood loss, larger incisions, prolonged operative time, and may impede patient recovery.<br /> AIM This work explored the feasibility, safety, and efficacy of using thulium laser enucleation of the pros- tate (ThuLEP) and thulium fiber laser (TFL) on a single-energy platform to treat BPH combined with<br /> MATERIALS AND METHODS Thirty -one patients with BPH complicated by BSs who underwent ThuLEP+TFL at our institution between October 2020 and September 2022 were included in the observation group, while 31 patients undergoing TUEP plus bladder lithotomy during the same period constituted the con- trol group. Data collection involved assessing differences in the International Prostate Symptom Score (IPSS), hemoglobin (Hb) levels, maximum urinary flow rate (Qmax), and quality of life (QoL) before and after surgery, along with follow -up results. RESULTS The patients in the observation group exhibited lower surgery duration, smaller postopera- tive decrease in Hb levels, shorter duration of postoperative indwelling catheterization, and proportion of American Society of Anesthesiologists (ASA) II patients, with a higher proportion of ASA I patients than the individuals in the control group (P <0.05). Additionally, in comparison with the control group, the patients in the observation group had lower postoperative IPSS scores and higher levels of Hb, Q and QoL score (P <0.05). There was no significant difference in the postoperative stone clearance rate between the 2 groups (P >0.05); however, the postoperative length of hospital stay was shorter in the observation group (P <0.05), with a higher incidence of complications in the control (P <0.05).<br /> CONCLUSIONS In summary, ThuLEP+TFL surgery was safe and feasible in treating BPH+BS, relieving the symptoms, and improving QoL.