How Is High Power (200w) Thulium Laser Vapoenucleation of the Prostate Impacting Functional Parameters? Short-Term Follow-Up Results

Abstract

Objective: To assess the efficacy and safety of thulium laser vapoenucleation of the prostate and its impact on patient’s lower urinary tract symptoms, erectile, and ejaculatory functions, we conducted the current prospective trial employing a high-power (200 W) Thulium: YAG laser system. Material and Methods: Between December 2021 and June 2022, we prospectively collected data on patients who underwent Thulium vapoenucleation of the prostate (ThuVEP) in our clinic to treat the signs and symptoms of benign prostatic hyperplasia. A sample size of 50 cases was obtained after applying exclusion criteria. In the first and sixth months following surgery, all patients were compared to their preoperative status in terms of lower urinary tract symptoms, erectile function, and ejaculatory symptoms. The Modified Clavien-Dindo Classification was also used to classify the complications that occurred. Results: The patients' IPSS scores showed a notable and significant improvement at the end of the 6-month follow-up. When compared to the preoperative state, erectile functions as measured by the IIEF-5 score did not significantly change with the surgery. At the end of the follow-up period, there was a substantial deterioration of ejaculatory functions as measured by the MSHQ-EjD score. During and after the procedure, complications at the Clavien 3a level were seen in 2 (4%) of the patients, but no complications above this level were seen. Conclusion: The ThuVEP method, used in the surgical management of symptomatic benign prostatic hyperplasia, is safe and effective in terms of functional outcomes despite high-power (200 W) vapoenucleation. In this field, further randomized controlled studies with extended follow-up are required.