Ignacio E. Vega-Tepos, Servicio de Urología, Hospital Covadonga Córdoba, Córdoba, Veracruz, México
José J. Moreno-Ortega, Servicio de Urología, Hospital Covadonga Córdoba, Córdoba, Veracruz, México
Idalberto Velázquez-Vidal, Unidad de Virología y Cáncer, Hospital Infantil de México Federico Gómez, Ciudad de México, México
Katherine M. Flores-Rosas, Departamento de VIH SIDA e ITS, Jurisdicción Sanitaria No. III Poza Rica, Veracruz, México
Introduction: Thulium laser enucleation was introduced in 2010. In contrast to other transurethral techniques, it is characterized by mechanical dissection of the adenoma with low energy use. Objective: To compares various existing thulium laser enucleation techniques, including a new technique, in terms of efficacy, safety, efficiency, and short-term outcomes for treating benign prostatic hyperplasia. Method: A comparative study was conducted involving 48 patients, aged 51 to 91, with obstructive benign prostatic hyperplasia. A total of 48 surgeries were performed, comparing traditional techniques (trilobar, Mushroom, Tangerina), photovaporization and a new three-point technique between May 2018 and June 2019. Results: Different thulium laser enucleation techniques showed varying rates of post-surgical complications. The trilobar technique ex-hibited the highest complication rate (33%). Statistical analysis did not reveal significant differences in bleeding between the trilobar and three-point techniques, indicating similarities in this aspect. Conclusions: The selection of a transurethral approach for benign prostatic hyperplasia will depend on the patient’s comorbidity, the surgeon’s experience, and the availability of enucleation instruments. A modification of the enucleation technique is proposed, based on anatomical knowledge and variations in energy type.
Keywords: Thulium. Prostate. Laser therapy.