Evidence map›Paper›PMID 42053844›Full record

Trial reportWorld journal of urology2026

Thulium fiber laser versus Holmium laser enucleation of the prostate: 24-month outcomes from a prospective randomized non-inferiority trial.

Maximilian Filzmayer, Cristina Cano Garcia, Miriam I Traumann, Matthias J Müller, Clara Humke, Philipp C Mandel, Luis A Kluth, Andreas Becker, Felix K-H Chun, Marina Kosiba

Abstract readComparative StudyRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Maximilian FilzmayerDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany. filzmayer@med.uni-frankfurt.de.ORCID http://orcid.org/0009-0005-5715-9965
Cristina Cano GarciaDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Miriam I TraumannDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Matthias J MüllerDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Clara HumkeDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Philipp C MandelDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Luis A KluthDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Andreas BeckerDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Felix K-H ChunDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.
Marina KosibaDepartment of Urology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare 24-month outcomes of Thulium fiber laser enucleation of the prostate (ThuFLEP) and Holmium laser enucleation of the prostate (HoLEP).

methodsA 24-month follow-up analysis of a prospective randomized trial including 150 patients (ThuFLEP n = 74, HoLEP n = 76) was conducted. Primary outcome was non-inferior International Prostate Symptom Score (IPSS) and quality of life (QoL) reduction. Secondary outcomes included urinary continence, medication use reduction, erectile and ejaculatory function, and late adverse events.

resultsAt 24 months, non-inferiority of ThuFLEP regarding IPSS and QoL was confirmed (p = 0.03). Median IPSS improved from 21 preoperatively to 3 after ThuFLEP and from 20 to 4 after HoLEP (p < 0.001), with no significant intergroup differences at any time point (all p > 0.1). Median QoL improved from 4 to 1 in both groups (p < 0.001), likewise without significant differences at any time point (all p > 0.3). Continence rates improved from 74.0% preoperatively to 90.0%, pad usage decreased from 89.8% to 25.4% and ICIQ-SF decreased from 5 to 3 points (all p < 0.001), without intergroup differences (all p > 0.1). Use of medication for lower urinary tract symptoms decreased from 89.4% to 7.7% (p < 0.001). Ejaculatory function declined, while ejaculation-related bother remained unchanged and erectile function improved modestly, all without intergroup differences (all p > 0.1). Three late adverse events occurred exclusively in the ThuFLEP group, without statistical significance (p > 0.1).

conclusionThuFLEP remains non-inferior to HoLEP for patient-reported functional outcomes at 24 months and demonstrates comparable safety, continence, medication use reduction, and sexual function results over time. Both techniques represent effective, durable and safe surgical options for treating benign prostatic obstruction. TRIAL REGISTRATION NUMBER: DRKS00032699 (18.09.2023, retrospectively registered).

Indexed as

Lasers, Solid-StateLaser TherapyProstatectomyProstatic HyperplasiaThuliumAgedFollow-Up StudiesHumansLower Urinary Tract SymptomsMaleMiddle AgedProspective StudiesQuality of LifeTime FactorsTreatment OutcomeThuliumFunctional outcomesHoLEPHolmium laserLaser enucleation of the prostateLower urinary tract symptomsSoLEPSoltive™ThuFLEPThulium fiber laser

Identifiers

PMID42053844
PMCPMC13128747

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.