Abstract：
BACKGROUND: Benign prostatic hyperplasia (BPH) commonly causes lower urinary tract symptoms (LUTS) in men. Holmium (HoLEP) and thulium (ThuLEP) laser enucleation are established techniques for BPH treatment. Thulium fiber laser (TFL) for prostate enucleation (ThuFLEP) shows promising outcomes.
METHODS: A prospective randomized multicenter study was conducted. Patients with BPH and LUTS unresponsive to medical therapy were enrolled. Preoperative, surgical, perioperative and postoperative data were recorded with follow-up at 3 and 6 months. The primary outcome was functional improvement, and the secondary outcome was safety in terms of complications.
RESULTS: Two hundred patients were included (HoLEP 100, ThuFLEP 100). No significant baseline difference was found between groups. At 3 and 6 months we found statistically significant improvements from baseline for both HoLEP and ThuFLEP in efficacy: International Prostatic Symptoms Score (IPSS), IPSS-Quality of Life (QoL), maximum urinary flow rate (Qmax ), and post-void residual volume (PVR; P<0.05). At 6 months, mean±SD IPSS, IPSS-QoL, Qmax , and PVR for HoLEP vs. ThuFLEP were 5.8±4.9 vs. 4.8±5.0 points (P=0.57), 1.6±1.4 vs. 0.7±1.1 points (P=0.09), 29.9±12.5 vs. 29.6±8.0 mL/s (P=0.8), and 16.3±17.7 vs. 15.5±13.4 mL (P=0.92), respectively. No intraoperative complication was recorded. No Clavien-Dindo ≥III complications occurred during hospitalization. After 6 months, 8 (8%) and 6 (6%) patients reported mild stress urinary incontinence in HoLEP and ThuFLEP groups, respectively (P=0.24). Urethral stenosis was observed in 3 men (3%) in the HoLEP group and 1 subject (1%) in the ThuFLEP group (P=0.72).
CONCLUSIONS: HoLEP and ThuFLEP are effective and safe for BPH treatment, with comparable functional outcomes and complication rates at 6 months. Further research is needed to confirm these findings.
METHODS: A prospective randomized multicenter study was conducted. Patients with BPH and LUTS unresponsive to medical therapy were enrolled. Preoperative, surgical, perioperative and postoperative data were recorded with follow-up at 3 and 6 months. The primary outcome was functional improvement, and the secondary outcome was safety in terms of complications.
RESULTS: Two hundred patients were included (HoLEP 100, ThuFLEP 100). No significant baseline difference was found between groups. At 3 and 6 months we found statistically significant improvements from baseline for both HoLEP and ThuFLEP in efficacy: International Prostatic Symptoms Score (IPSS), IPSS-Quality of Life (QoL), maximum urinary flow rate (Q
CONCLUSIONS: HoLEP and ThuFLEP are effective and safe for BPH treatment, with comparable functional outcomes and complication rates at 6 months. Further research is needed to confirm these findings.
摘要：
背景：良性前列腺增生（BPH）通常会导致男性下尿路症状（LUTS）。钬（HoLEP）和cliium（ThuLEP）激光摘除是BPH治疗的既定技术。Thulium光纤激光（TFL）用于前列腺摘除（ThuFLEP）显示出有希望的结果。
方法：进行前瞻性随机多中心研究。纳入对药物治疗无反应的BPH和LUTS患者。术前,外科,记录围手术期及术后3个月和6个月的随访数据。主要结果是功能改善，次要结局是并发症的安全性.
结果：纳入200名患者（HoLEP100，ThuFLEP100）。组间没有发现显著的基线差异。在3个月和6个月时，我们发现HoLEP和ThuFLEP的疗效与基线相比有统计学上的显着改善：国际前列腺症状评分（IPSS），IPSS-生活质量(QoL)，最大尿流率（Qmax ），和后空隙残余体积（PVR；P<0.05）。6个月时,平均值±SDIPSS，IPSS-QoL,Qmax ,和PVRforHoLEPvs.ThuFLEP为5.8±4.9vs.4.8±5.0分(P=0.57),1.6±1.4vs.0.7±1.1分(P=0.09),29.9±12.5vs.29.6±8.0mL/s(P=0.8),和16.3±17.7vs.15.5±13.4mL（P=0.92），分别。术中无并发症记录。住院期间无Clavien-Dindo≥III并发症发生。六个月后,在HoLEP和ThuFLEP组中，有8例（8%）和6例（6%）患者报告轻度压力性尿失禁，分别为(P=0.24)。在HoLEP组中3例男性（3％）和ThuFLEP组中1例受试者（1％）观察到尿道狭窄（P=0.72）。
结论：HoLEP和ThuFLEP对于BPH治疗是有效和安全的，6个月时具有相当的功能结局和并发症发生率。需要进一步的研究来证实这些发现。
方法：进行前瞻性随机多中心研究。纳入对药物治疗无反应的BPH和LUTS患者。术前,外科,记录围手术期及术后3个月和6个月的随访数据。主要结果是功能改善，次要结局是并发症的安全性.
结果：纳入200名患者（HoLEP100，ThuFLEP100）。组间没有发现显著的基线差异。在3个月和6个月时，我们发现HoLEP和ThuFLEP的疗效与基线相比有统计学上的显着改善：国际前列腺症状评分（IPSS），IPSS-生活质量(QoL)，最大尿流率（Q
结论：HoLEP和ThuFLEP对于BPH治疗是有效和安全的，6个月时具有相当的功能结局和并发症发生率。需要进一步的研究来证实这些发现。
