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Volume 12 Issue 4 ( October-December ) 2023

Original Articles

Holmium Laser Enucleation Vs Thulium Laser Enucleation- A Comparative Study (Do We have a Winner)
Dr. Debanga Sarma, Dr. Mandeep Phukan, Dr. Kishlaya Atharwa, Dr. Nabajeet Das, Dr. Puskal Kumar Bagchi, Dr. Sasanka Kumar Barua

Purpose: In the last decades, HoLEP has become the most frequent intervention for BPH. In the hands of an experienced surgeon, improvements in urodynamics parameters are similar to those of other techniques of BPH surgery. When matched with Holmium LASER, there are several potential advantages to using Thulium LASER, such as rapid vaporisation, the ability to coagulate, better spatial beam quality, precise tissue incision, etc. When compared with the historical gold standard, transurethral resection of the prostate (TURP), HoLEP and other enucleation techniques such as bipolar enucleation have shown superior efficacy in tissue retrieval . We aimed to compare the outcomes following enucleation using Holmium and Thulium LASER. Materials and Methods: Our study included patients who satisfied both our inclusion and exclusion criteria. We compared the weight of prostate tissue enucleated, total enucleation time, the improvement in IPSS Score, improvement in Qmax, changes in PVR and other parameters at regular intervals of follow-up . All the surgeries were performed by a single surgeon. Results: In total, 42 patients underwent HoLEP and 44 patients underwent ThuLEP. On postoperative follow up patients were evaluated for improvement in IPSS score which was comparable in both arms. With HoLEP, the quantity of tissue enucleated postoperatively was greater with p value <0.0001. ThuLEP procedure was faster than HoLEP with p value <0.0001. Immediate postoperatively HoLEP patients experienced less dysuria compared to ThuLEP patients. Conclusion: Both HoLEP and ThuLEP alleviate lower urinary tract symptoms in a safe and effective manner. HoLEP was statistically superior to ThuLEP in amount of tissue enucleated and less post operative complications.

 
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