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HoLEP、ThuLEP 和 ThuFLEP 治疗良性前列腺梗阻的比较:倾向评分匹配分析。

Comparison of HoLEP, ThuLEP and ThuFLEP in the treatment of benign prostatic obstruction: a propensity score-matched analysis.

机构信息

Polatlı Duatepe State Hospital, Clinic of Urology, Ankara, Turkey.

Department of Urology, SLK Kliniken Heilbronn, Heilbronn, Germany.

出版信息

World J Urol. 2024 Jun 13;42(1):374. doi: 10.1007/s00345-024-05082-2.


DOI:10.1007/s00345-024-05082-2
PMID:38871959
Abstract

PURPOSE: To compare the efficacy and safety of Holmium laser enucleation of the prostate (HoLEP), Thulium laser enucleation of prostate (ThuLEP) and Thulium fibre laser enucleation of prostate (ThuFLEP) by performing propensity score matched analysis (PSM). METHODS: We retrospectively analysed the patients who underwent HoLEP (Group 1, n = 696), ThuLEP (Group 2, n = 146) and ThuFLEP (Group 3, n = 193) surgery because of benign prostatic obstruction (BPO). A 1:1:1 HoLEP: ThuLEP: ThuFLEP group matching was performed using PSM analysis. Perioperative, postoperative functional outcomes and complications were analysed and compared. RESULTS: We observed significant improvement in functional parameters regarding IPSS, Qmax, PVR and quality of life in all groups compared to baseline values at the 1st, 6th and 12th postoperative months. There was no significant difference between different laser types in terms of urge (UUI) and stress urinary incontinence (SUI) at 1st postoperative month. In all three groups, no patient had postoperative SUI or UUI at 6th and 12th postoperative months. In addition, no significant difference was observed between laser types in terms of postoperative complications. CONCLUSION: HoLEP, ThuLEP and ThuFLEP are safe and effective LEP methods with improvement in functional parameters and low complication rates. Similar results in terms of functional outcomes and complications clearly show that these surgeries are alternatives to each other for the patients with BPO. Experts' opinions, practices and enucleation techniques should also be taken into consideration when choosing a laser for BPO surgery.

摘要

目的:通过倾向评分匹配分析(PSM)比较钬激光前列腺剜除术(HoLEP)、铥激光前列腺剜除术(ThuLEP)和铥光纤激光前列腺剜除术(ThuFLEP)的疗效和安全性。

方法:我们回顾性分析了因良性前列腺梗阻(BPO)接受 HoLEP(第 1 组,n=696)、ThuLEP(第 2 组,n=146)和 ThuFLEP(第 3 组,n=193)手术的患者。采用 PSM 分析对 1:1:1 HoLEP:ThuLEP:ThuFLEP 组进行匹配。分析并比较了围手术期、术后功能结果和并发症。

结果:与基线相比,我们观察到所有组在第 1、6 和 12 个月的术后 IPSS、Qmax、PVR 和生活质量的功能参数均有显著改善。在术后第 1 个月,不同激光类型之间在急迫性尿失禁(UUI)和压力性尿失禁(SUI)方面没有显著差异。在所有三组中,术后第 6 和第 12 个月均无患者发生术后 SUI 或 UUI。此外,激光类型之间在术后并发症方面没有观察到显著差异。

结论:HoLEP、ThuLEP 和 ThuFLEP 是安全有效的 LEP 方法,可改善功能参数并降低并发症发生率。在功能结果和并发症方面的相似结果清楚地表明,这些手术是 BPO 患者的替代方案。在选择用于 BPO 手术的激光时,还应考虑专家的意见、实践和剜除技术。

相似文献

[1]
Comparison of HoLEP, ThuLEP and ThuFLEP in the treatment of benign prostatic obstruction: a propensity score-matched analysis.

World J Urol. 2024-6-13

[2]
Comparison Between Thulium Fiber Laser and High-power Holmium Laser for Anatomic Endoscopic Enucleation of the Prostate: A Propensity Score-matched Analysis from the REAP Registry.

Eur Urol Focus. 2024-1

[3]
Prospective randomized multicenter study to evaluate holmium vs. new thulium fiber laser for prostate enucleation.

Minerva Urol Nephrol. 2024-8

[4]
HoLEP versus ThuFLEP in men with very large prostates (> 175 ml).

World J Urol. 2025-2-7

[5]
A prospective multicenter randomized comparison between Holmium Laser Enucleation of the Prostate (HoLEP) and Thulium Laser Enucleation of the Prostate (ThuLEP).

World J Urol. 2021-7

[6]
The safety and efficacy of five surgical treatments in prostate enucleation: a network meta-analysis.

BMC Urol. 2024-6-17

[7]
Randomized prospective trial of the severity of irritative symptoms after HoLEP vs ThuFLEP.

World J Urol. 2022-8

[8]
A randomized trial of holmium laser vs thulium laser vs bipolar enucleation of large prostate glands.

BJU Int. 2023-12

[9]
Holmium laser enucleation of the prostate versus thulium laser enucleation of the prostate for the treatment of large-volume prostates > 80 ml: 18-month follow-up results.

World J Urol. 2020-6

[10]
Thulium fiber laser vs. holmium laser enucleation of the prostate: results of a prospective randomized non-inferiority trial.

World J Urol. 2024-1-20

引用本文的文献

[1]
Thulium fiber laser versus holmium MOSES laser enucleation of the prostate for the treatment of benign prostatic hyperplasia: a randomized prospective clinical study.

Prostate Cancer Prostatic Dis. 2025-7-8

[2]
A comparison of TURP, HoLEP, and RFA for nonneurogenic LUTS in men.

Turk J Med Sci. 2024-12-20

[3]
The Impact of Transurethral Enucleation Therapeutic Approach in All-Size Benign Prostatic Obstruction Pathology: From Contemporary Technological Advances to Evidence-Based Clinical Progresses.

Diagnostics (Basel). 2025-2-8

[4]
Exploring the optimal parameter settings of a thulium fiber laser during soft tissue resection.

Lasers Med Sci. 2025-2-25

[5]
HoLEP versus ThuFLEP in men with very large prostates (> 175 ml).

World J Urol. 2025-2-7

本文引用的文献

[1]
Experts' recommendations in laser use for the treatment of upper tract urothelial carcinoma: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training Research in Urological Surgery and Technology (T.R.U.S.T.) group.

World J Urol. 2023-11

[2]
A Delphi consensus to standardize the technique of anatomical endoscopic enucleation of prostate: a study by ESUT endoscopic enucleation of prostate study group.

World J Urol. 2023-9

[3]
Thulium Fiber Laser: Bringing Lasers to a Whole New Level.

Eur Urol Open Sci. 2022-12-20

[4]
Randomized prospective trial of the severity of irritative symptoms after HoLEP vs ThuFLEP.

World J Urol. 2022-8

[5]
Thulium Fiber Laser Enucleation of the Prostate: Prospective Study of Mid- and Long-Term Outcomes in 1328 Patients.

J Endourol. 2022-9

[6]
Laser enucleation for prostates larger than 100 mL: Comparison of HoLEP and ThuLEP.

Andrologia. 2021-9

[7]
Holmium Versus Thulium Laser Enucleation of the Prostate: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Eur Urol Focus. 2022-3

[8]
HoLEP after prostate biopsy: does it have any impact?

World J Urol. 2021-7

[9]
Ex vivo study of Ho:YAG and thulium fiber lasers for soft tissue surgery: which laser for which case?

Lasers Med Sci. 2022-2

[10]
A prospective multicenter randomized comparison between Holmium Laser Enucleation of the Prostate (HoLEP) and Thulium Laser Enucleation of the Prostate (ThuLEP).

World J Urol. 2021-7

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