Comparison of thulium laser enucleation and plasmakinetic resection of the prostate in a randomized prospective trial with 5-year follow-up

The aim of this study was to compare the clinical outcomes between thulium laser enucleation of the prostate (ThuLEP) and plasmakinetic bipolar resection of the prostate (PKRP) for treating benign prostatic hyperplasia (BPH) in a prospective randomized trial with 5 years of follow-up. One hundred fifty-eight consecutive patients with BPH were randomized to receive operation of either ThuLEP (n = 79) or PKRP (n = 79). All cases were evaluated preoperatively, and a part of them were evaluated at 3–5 years postoperatively by the International Prostate Symptom Score (IPSS), quality of life score (QoLS), maximum flow rate (Qmax), and postvoid residual (PVR) urine volume. Eighty patients completed the 5-year follow-up. Each study arm showed no significant difference in preoperative parameters. Compared with PKRP, ThuLEP required longer operation time (65.4 vs 47.4 min, p = 0.022) but resulted in less hemoglobin decrease (1.5 vs 3.0 g/L, p = 0.045), catheterization time (2.1 vs 3.5 days, p = 0.031), irrigated volume (12.4 vs 27.2 L, p = 0.022), and hospital stay (2.5 vs 4.6 days, p = 0.026). During the 60-month follow-up, both procedures demonstrated no significant difference in terms of Qmax, IPSS, PVR urine volume, and QoLS. ThuLEP was statistically superior to PKRP in blood loss, catheterization time, irrigated volume, and hospital stay but inferior to PKRP in operation time. However, both procedures showed no significant difference in terms of Qmax, IPSS, PVR urine volume, and QoLS through the 60-month follow-up.