Introduction & Objectives
\nContemporary urology training pathways are increasingly incorporating surgeons directly into robotic programs without priorlaparoscopic experience, raising concerns about whether the absence of conventional minimally invasive training may compromiselong-term surgical performance. Clinical evidence specifically evaluating the high-peak-power pulsed solid-state Thulium:YAGsystem (Dornier Thulio\u00ae) remains limited, particularly in large prostates. This study compared perioperative safety and earlyfunctional outcomes between pulsed Thulium:YAG laser enucleation (p-ThuLEP) and open simple prostatectomy (OSP) in patientswith prostate volumes of 80\u2013150 mL.
\nMaterials & Methods
\nA retrospective, single-center observational study was conducted including 98 consecutive patients treated with p-ThuLEP (n=49) orOSP (n=49) between January 2023 and May 2025. Cases were selected in a 1:1 ratio to obtain comparable group sizes. Theprimary outcome was bleeding-related complications (transfusion and postoperative hematuria). Secondary outcomes includedperioperative parameters and early functional results (IPSS, Qmax, PSA). Multivariable logistic regression was performed adjustingfor prostate volume, anticoagulant use, and positive urine culture.
\nResults
\np-ThuLEP significantly reduced hospital stay (mean difference \u22123.04 days; 95% CI \u22124.09 to \u22122.16; p=0.002) and catheterization time(mean difference \u22126.42 days; 95% CI \u22127.85 to \u22124.73; p=0.001). Transfusion rates were significantly lower in the p-ThuLEP group(0% vs 12.2%, p=0.012), as was postoperative hematuria (4.1% vs 16.3%, p=0.045). Overall complication rates were comparable(p=0.828), with most events classified as Clavien\u2013Dindo I\u2013II. Both groups demonstrated comparable early improvements in IPSSand Qmax. In multivariable analysis, anticoagulant use independently predicted hematuria (OR 9.39; 95% CI 1.56\u201356.45; p=0.014);surgical approach showed a strong but non-significant association (OR 5.84; 95% CI 0.95\u201335.92; p=0.057).
\nConclusions
\nIn this real-world series, p-ThuLEP was associated with significantly lower perioperative morbidity and transfusion rates comparedwith OSP, while early functional outcomes were comparable. These findings support p-ThuLEP as a feasible minimally invasiveoption for large-gland BPH in experienced centers, and provide novel real-world data for this high-peak-power pulsed platform.Prospective studies are warranted to confirm long-term durability.<\/p>","protected":false},"excerpt":{"rendered":"
Introduction & Objectives Contemporary urology training pathways are increasingly incorporating surgeons directly into robotic programs without priorlaparoscopic experience, raising concerns about whether the absence of conventional minimally invasive training may compromiselong-term surgical performance. Clinical evidence specifically evaluating the high-peak-power pulsed … read more<\/a><\/p>","protected":false},"author":3,"featured_media":191,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-190","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/190","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/191"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=190"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=190"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=190"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}