Thulium laser versus standard transurethral resection of the prostate: A randomized prospective trial

Objective: Thulium laser resection of the prostate-tangerine technique (TmLRP-TT) is a transurethral procedure that uses thulium laser fiber to dissect whole prostatic lobes off the surgical capsule, similar to peeling a tangerine. To our knowledge we report the first prospective, randomized study comparing TmLRP-TT and standard TURP for symptomatic BPH. Methods: From November 2004 to December 2005, 100 consecutive BPH patients were randomized for surgical treatment with TmLRP-TT (n = 52) or TURP (n = 48). All patients were preoperatively assessed with subjective symptoms score, International Index of Erectile Function questionnaire, and complete urodynamic evaluation. Preoperative and perioperative parameters at 1-, 6-, and 12-mo follow-up were also evaluated. All complications were recorded. Results: TmLRP-TT was significantly superior to TURP in terms of catheterization time (45.7 +/- 25.8 h vs. 87.4 +/- 33.8 h, p < 0.0001), hospital stay (115.1 +/- 25.5 h vs. 161.1 +/- 33.8 h, p < 0.0001), and drop in hemoglobin (0.92 +/- 0.82 g/dl vs. 1.46 +/- 0.65 g/dl, p < 0.001), whereas it required equivalent time to perform (46.3 +/- 16.2 vs. 50.4 +/- 20.7 min, p > 0.05). TmLRP-TT and TURP resulted in a significant improvement from baseline in terms of subjective symptoms scoring and urodynamic finding, but no significant difference was found between the two groups. Late complications were also comparable. Conclusions: TmLRP-TT is an almost bloodless procedure with high efficacy and little perioperative morbidity. TmLRP-TT is superior to TURP in safety and is as efficacious as TURP in 1-yr follow-up. It is a promising technology in the clinical practice field. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.