ArticleTranslational andrology and urology2026
Pulsed Thulium:YAG laser enucleation versus open simple prostatectomy for large-gland benign prostatic hyperplasia: a retrospective comparative observational study.
Article in Translational andrology and urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Evidence on high-peak-power pulsed Thulium:YAG laser enucleation (p-ThuLEP) remains limited, particularly for large prostates. This study aimed to compare perioperative, functional, and safety outcomes between p-ThuLEP and open simple prostatectomy (OSP) in patients with large-gland benign prostatic hyperplasia (BPH). We compared early perioperative, functional, and bleeding-related outcomes between p-ThuLEP and OSP in patients with large-gland BPH. Methods: We conducted a retrospective comparative observational study including 98 consecutive patients with prostate volumes 80-150 mL treated between January 2023 and May 2025 in a tertiary academic center. Cases were selected in a 1:1 ratio to obtain comparable group sizes; no formal matching procedure was performed. The primary outcome was bleeding-related complications (transfusion and postoperative hematuria). Secondary outcomes included perioperative parameters and early functional results [International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), prostate-specific antigen (PSA)]. Multivariable logistic regression adjusted for prostate volume, anticoagulant use, and positive urine culture. Results: p-ThuLEP significantly reduced hospital stay [mean difference -3.04 days; 95% confidence interval (CI): -4.09 to -2.16; P=0.002] and catheterization time (mean difference -6.42 days; 95% CI: -7.85 to -4.73; P=0.001), as well as transfusion rates (0% Conclusions: In this real-world cohort of large prostates, no significant differences in early functional outcomes were detected between p-ThuLEP and OSP, while p-ThuLEP was associated with shorter hospitalization and lower transfusion rates. Given the retrospective design and short follow-up, these findings primarily reflect early perioperative and short-term results. p-ThuLEP may represent a minimally invasive option in experienced centers. Prospective studies are warranted to confirm long-term durability.
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