Thulium laser enucleation (ThuLEP) versus transurethral resection of the prostate in saline (TURis): A randomized prospective trial to compare intra and early postoperative outcomes

Actas Urol Esp. 2017 Jun;41(5):309-315. doi: 10.1016/j.acuro.2016.06.010. Epub 2017 Jan 3.
[Article in English, Spanish]


Objective: To compare clinical intra and early postoperative outcomes between thulium laser transurethral enucleation of the prostate (ThuLEP) and transurethral bipolar resection of the prostate (TURis) for treating benign prostatic hyperplasia (BPH) in a prospective randomized trial.

Methods: The study randomized 208 consecutive patients with BPH to ThuLEP (n=102) or TURis (n=106). For all patients were evaluated preoperatively with regards to blood loss, catheterization time, irrigation volume, hospital stay and operative time. At 3 months after surgery they were also evaluated by International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), and postvoid residual urine volume (PVR).

Results: The patients in each study arm each showed no significant difference in preoperative parameters. Compared with TURIS, ThuLEP had same operative time (53.69±31.44 vs 61.66±18.70minutes, P=.123) but resulted in less hemoglobin decrease (0.45 vs 2.83g/dL, P=.005). ThuLEP also needed less catheterization time (1.3 vs 4.8 days, P=.011), irrigation volume (29.4 vs 69.2 L, P=.002), and hospital stay (1.7 vs 5.2 days, P=.016). During the 3 months of follow-up, the procedures did not demonstrate a significant difference in Qmax, IPSS, PVR, and QOLS.

Conclusion: ThuLEP and TURis both relieve lower urinary tract symptoms equally, with high efficacy and safety. ThuLEP was statistically superior to TURis in blood loss, catheterization time, irrigation volume, and hospital stay. However, procedures did not differ significantly in Qmax, IPSS, PVR, and QOLS through 3 months of follow-up.

Keywords: Benign prostatic hiperplasia; Hiperplasia benigna de próstata; Resección bipolar transuretral de la próstata; Thulium laser transurethral enucleation of the prostate; Transurethral bipolar resection of the prostate; enucleación transuretral con láser de tulio de la próstata.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Humans
  • Laser Therapy*
  • Male
  • Prospective Studies
  • Prostatectomy / methods*
  • Prostatic Hyperplasia / surgery*
  • Sodium Chloride
  • Thulium*
  • Time Factors
  • Transurethral Resection of Prostate
  • Treatment Outcome


  • Sodium Chloride
  • Thulium