Introduction: Benign prostatic enlargement has been a major part of urology and its treatment has been challenged by numerous technologies arising as the years go by. TURP remains a standard in comparison to new techniques that has been introduced. Recently laser, specifically thulium:yag, has been found to be a promising contender for TURP.
Techniques: Two techniques are available when using thulium:yag laser for the benign prostate. It includes laser enucleation which involves the use of a morcellator and vaporesection which is done if the morcellator is not available.
Outcomes and complications: Based on numerous studies, outcomes and complication rates of TLRP compared to that of TURP is very much comparable.
Conclusion and recommendations: TLRP is relatively safe and practical and offers a good alternative to TURP. Results from various studies with this new laser technology are encouraging.
Fried NM, Murray KE. High-power thulium fiber laser ablation of urinary tissues at 1.94 micron. J Endourol. 2005;19:25–31.CrossRefGoogle Scholar
Gross A, Netsch C, Knipper S, Hölzel J, Bach T. Complications and early postoperative outcome in 1080 patients after thulium vapoenucleation of the prostate: results at a single institution. Euro Urol. 2013;63:859–67.CrossRefGoogle Scholar
Iacono F, et al. Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients. BMC Surg. 2012;12:1471–2.CrossRefGoogle Scholar
Kim JW, et al. An analytical comparison of short-term effectiveness and safety between Thulium:YAG laser vaporesection of the prostate and bipolar transurethral resection of the prostate in patients with benign prostatic hyperplasia. Korean J Urol. 2014;55(1):41–6.CrossRefGoogle Scholar
Lerner LB, Rajender A. Laser prostate enucleation techniques. Can J Urol. 2015;22(Suppl 1):53–9.PubMedGoogle Scholar
Mrkobrada M, Ying I, Mokrycke S, Dresser G, Elsayed S, Bathini V, Boyce E, Luke P. CUA guidelines on antibiotic prophylaxis for urologic procedures. Can Urol Assoc J. 2015;9(1–2):13–22.CrossRefGoogle Scholar
Rausch S, Heider T, Bedke J, et al. Analysis of early morbidity and functional outcome of thulium:yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome. Urology. 2015;85(1):182–8.CrossRefGoogle Scholar
Stuart Wolf Jr J, et al. Urologic surgery antimicrobial prophylaxis. Am Urol Assoc. 2016.Google Scholar
Swiniarski P, Stepien S, Dudzic W, et al. Thulium laser enucleation of the prostate (TmLEP) vs. transurethral resection of the prostate (TURP): evaluation of early results. Cent Euro J Urol. 2012;65(3):130–4.CrossRefGoogle Scholar
Szlauer R, Götschl R, Razmaria A, Paras L, Schmeller NT. Endoscopic vaporesection of the prostate using the continuouswave 2-μm thulium laser: outcome and demonstration of the surgical technique. Euro Urol. 2009;55:368–75.CrossRefGoogle Scholar
Vartak Ketan P, et al. Thulium laser enucleation of the prostate is a safe and a highly effective modality for the treatment of benign prostatic hyperplasia: our experience of 236 patients. Urol Ann. 2016;8(1):76–80.CrossRefGoogle Scholar
Wendt-Nordahl G, et al. Systematic evaluation of a recently introduced 2-microm continuous-wave thulium laser for vaporesection of the prostate. J Endourol. 2008;22:1041–5.CrossRefGoogle Scholar
Worthington J, et al. A randomised controlled trial to determine the clinical and cost effectiveness of thulium laser transurethral vaporesection of the prostate (ThuVARP) versus transurethral resection of the prostate (TURP) in the National Health Service (NHS)—the UNBLOCS trial: a study protocol for a randomised controlled trial. Trials. 2017;18(1):179.CrossRefGoogle Scholar
Yan H, et al. Thulium laser vaporesection versus standard transurethral resection of the prostate: a randomized trial with transpulmonary thermodilution hemodynamic monitoring. Int J Urol. 2013;20(5):507–12.CrossRefGoogle Scholar
Yang Z, Wang X, Liu T. Thulium laser enucleation versus plasmakinetic resection of the prostate: a randomized prospective trial with 18-month follow-up. Urology. 2013;81(2):396–400.CrossRefGoogle Scholar
Zhang F, Shao Q, Herrmann T, Tian Y, Zhang Y. Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center. Urology. 2012;79(4):869–74.CrossRefGoogle Scholar