Randomized prospective trial of the severity of irritative symptoms after HoLEP vs ThuFLEP

Enikeev, Dmitry; Taratkin, Mark; Babaevskaya, Diana; Morozov, Andrey; Petov, Vladislav; Sukhanov, Roman; Shpot, Evgeny; Misraï, Vincent; Chinenov, Denis; Enikeev, Mikhail; Herrmann, Thomas

doi:10.1007/s00345-022-04046-8

Cited by 21 publications

(16 citation statements)

References 28 publications

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“…No differences in functional outcomes (IPSS, Qmax), rate of SUI or irritative symptoms were found. Both surgeries were comparable in terms of duration and postoperative complication rates (38).…”

Section: Thulium Fiber Laser For Soft Tissues: Clinical Trialsmentioning

confidence: 93%

“…The safety profile for ThuFLEP also was also acceptable with an overall complication rate of 9.7%, Clavien-Dindo grade III complications only in 1.9% of cases (37). Also, Enikeev et al compared the severity of irritative symptoms after HoLEP and ThuFLEP (38). No differences in functional outcomes (IPSS, Qmax), rate of SUI or irritative symptoms were found.…”

Section: Thulium Fiber Laser For Soft Tissues: Clinical Trialsmentioning

confidence: 99%

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Thulium fiber laser in BPH surgery: Bench to bedside - a systematic review on behalf of YAU Urotechnology Working Group

et al. 2022

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IntroductionThe Thulium fiber laser (TFL) is a new device that in contrast to the other solid-state YAG-based lasers takes a different approach to pulse formation allowing for two different modes: in the QCW (quasi-continuous wave) function, TFL is convenient for soft tissue surgery and in the SP (Superpulsed) mode it is highly effective in lithotripsy. Thus, unlike the other thulium lasers (Tm : YAG), TFL can be used in a wide range of surgical procedures.Materials and MethodsWe conducted a systematic search in 3 databases: Medline, Scopus and Cochrane library. All original articles (both preclinical and clinical) on TFL application in soft tissue surgery were included in data analysis.ResultsIn terms of its cutting properties, QCW TFL is not inferior to the other thulium lasers, and in fact allows for decreased carbonization (due to lower heat production) compared to continuous lasers (e.g. Tm : YAG). It has been used successfully in endoscopic enucleation of the prostate (EEP) and in en bloc resection of bladder tumors (ERBT). The efficacy and safety of this laser is comparable to TURP and simple prostatectomy, but the recovery period is shorter and the learning curve is slightly superior to other endoscopic procedures. There are no significant differences between TFL and Ho : YAG in terms of efficacy and safety during EEP. Unfortunately, there are no clinical studies that analyse the efficacy and safety of SP TFL in EEP or ERBT.ConclusionTFL is a safe and effective tool for BPH surgery. In terms of parameters, it is in no way inferior to Tm : YAG or Ho : YAG during EEP. However, TFL surpasses these lasers in terms of usability and serviceability. These advantages are likely to render it more popular over time.

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Section: Thulium Fiber Laser For Soft Tissues: Clinical Trialsmentioning

confidence: 93%

Section: Thulium Fiber Laser For Soft Tissues: Clinical Trialsmentioning

confidence: 99%

Thulium fiber laser in BPH surgery: Bench to bedside - a systematic review on behalf of YAU Urotechnology Working Group

et al. 2022

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“…At the same time, studies devoted to comparing the results of enucleation performed with Tm-fiber and other energy sources are limited to several publications. To date, it has been shown that thulium fiber laser enucleation of the prostate (ThuFLEP) has some advantages over classic transurethral resection [ 8 ] and open adenomectomy [ 9 ], with the same effectiveness as ThuLEP [ 10 ] and HoLEP [ 11 ]. However, no work in the literature has compared ThuFLEP and the most economical and affordable bipolar enucleation.…”

Section: Introductionmentioning

confidence: 99%

Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up

Kamalov,

Sorokin,

Dzitiev

et al. 2024

Investig Clin Urol

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Purpose To compare perioperative, functional, and safety outcomes between thulium fiber laser enucleation of the prostate (ThuFLEP) and bipolar enucleation of the prostate performed by a single surgeon with use of propensity score (PS)-matched analysis. Materials and Methods Data were from 675 patients, 422 of whom underwent ThuFLEP and bipolar enucleation by a single highly experienced surgeon. ThuFLEP was performed with Fiberlase U1 (IRE Polus Ltd.). Perioperative parameters, safety, and functional outcomes, such as International Prostate Symptom Score (IPSS), quality of life (QoL), postvoid residual volume (PVR), and maximum urinary flow rate (Qmax) were assessed. To control for selection bias, a 1:1 PS-matched analysis was carried out using the following variables as covariates: total prostate volume, preoperative IPSS and early sphincter release. Results Of 422 patients, 370 (87.7%) underwent ThuFLEP and 52 (12.3%) underwent bipolar enucleation. Operation, enucleation, and morcellation time were comparable between groups before and after PS-matched analysis (p=0.954, p=0.474, p=0.362, respectively). Functional parameters (IPSS, QoL, PVR, Qmax) were also comparable between groups at every time point before and after PS matching. Significant improvements in IPSS, QoL score, Qmax, and PVR were observed during the 24-month follow-up period for both ThuFLEP and bipolar enucleation without any significant differences between groups. Early and late postoperative complications before and after PS-matched analysis were similar. Conclusions ThuFLEP was comparable to bipolar enucleation in perioperative characteristics, improvement in voiding parameters, and complication rates. Both procedures were shown to be effective and safe in the management of benign prostatic hyperplasia.

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“…There is scarce evidence comparing holmium and thulium fiber laser enucleation (HoLEP and ThuFLEP). Both ThuFLEP and HoLEP are efficient ways of treating BPO and showed no apparent differences in functional outcomes in a recent study [17] .…”

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confidence: 96%

Long Live Holmium!

Socarrás¹,

Álamo²,

Sancha³

2023

European Urology Open Science

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Randomized prospective trial of the severity of irritative symptoms after HoLEP vs ThuFLEP

Cited by 21 publications

References 28 publications

Thulium fiber laser in BPH surgery: Bench to bedside - a systematic review on behalf of YAU Urotechnology Working Group

Thulium fiber laser in BPH surgery: Bench to bedside - a systematic review on behalf of YAU Urotechnology Working Group

Propensity score-matched analysis comparing perioperative, functional, and safety outcomes between thulium fiber laser and bipolar enucleation of the prostate performed by a single surgeon with two years of follow-up

Long Live Holmium!

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