Urology and Andrology

A comparison of the efficacy of thulium laser enucleation of prostatic adenoma and retropubic adenomectomy

The objective. Assessment of the efficacy and safety of thulium laser enucleation in comparison with traditional retropubic adenomectomy for removal of benign prostatic hyperplasia (BPH).

Materials and methods. We analysed 98 medical histories of patients treated in the urology clinic of the Sechenov University over the period from January 2013 to June 2017. The first group of patients (n = 40) underwent retropubic adenomectomy, the second (n = 58) – thulium laser enucleation of the prostate. The main criteria for inclusion were: prostate volume more than 80 cm3; IPSS (International Prostate Symptom Score) >20; Qmax (the maximum urine flow rate) <12. 

Results. In patients with a history of retropubic adenomectomy, a significant decrease of haemoglobin levels was noted (by 3.2 g/dL) on the third day after surgery as compared with thulium laser enucleation (by 1.0 g/dL). Duration of catheterization after retropubic adenomectomy averaged 9.4 days, whereas in most patients (79%) after thulium laser enucleation a catheter was removed on the first day.

Conclusion. Despite an equally high efficacy of retropubic adenomectomy and thulium laser enucleation of the prostate (ThuLEP) in management of infravesical obstruction associated with BPH, the number of complications arising after open surgery is higher than after ThuLEP. Moreover, thulium laser enucleation permits patients to faster return to the normal rhythm of life, does not require placement of surgical drains and considerably reduces the duration of hospitalisation and rehabilitation.

Key words: prostate, benign hyperplasia, thulium laser enucleation, retropubic adenomectomy.

For citation: Glybochko P.V., Alyaev Yu.G., Rapoport L.M., Enikeev D.V., Enikeev M.E., Spivak L.G., R.R.Kharchilava, Khamraev O.Kh., Gaas M.Ya., Inoyatov Zh.Sh., Taratkin M.S. A comparison of the efficacy of thulium laser enucleation of prostatic adenoma and retropubic adenomectomy. Vopr. urol. androl. (Urology and Andrology). 2017; 5(4): 13–18. (In Russian).
DOI: 10.20953/2307-6631-2017-4-13-18