MP25-19 GREENLIGHT 532NM LASER VS. THULIUM LASER ENUCLEATION OF THE PROSTATE FOR TREATMENT OF LARGE SIZED BENIGN PROSTATIC HYPERPLASIA; RESULTS OF RANDOMIZED CONTROLLED TRIAL

INTRODUCTION AND OBJECTIVE: To compare continuous wave length lasers; Greenlight 532nm laser enucleation of the prostate (Green LEP) vs. thulium laser enucleation of the prostate (THULEP) in reduction of lower urinary tract symptoms secondary to large sized benign prostate obstruction (BPO) METHODS: A total of 109 eligible patients with prostate size above 80ml were randomized to ThuLEP (55) and GreenLEP (54). Patients were assessed preoperatively, 1,3, 6 and 12 months postoperatively. Baseline characteristics of the patients, perioperative data, postoperative outcomes, and complications were recorded and compared (Table 1, Fig 1). Primary endpoint entails change of IPSS at 12 months. Other urinary parameters :QOL, Qmax and PVR were also compared. Secondary endpoints included: enucleation efficiency, percent of PSA reduction, perioperative complications and length of hospital stay. RESULTS: Patient age was 67±6.4 and 65.4±6.6 years for ThuLEP and GreenLEP, respectively. The mean preoperative prostate size was 128±34.3 and 112.6±28 ml in ThuLEP and GreenLEP groups, respectively. In both groups, the mean± IPSS showed significant improvement at 1,3 ,6 and 12 months follow up visits compared to preoperative values (p<0.0001) with no significant differences between both groups. These improvements were evident in both catheterized and non catheterized patients. Improvements were evident in both storage and voiding subdomains. At 12 months, urinary flow parameters improved significantly in both groups compared with the baseline values (Figure 1). Enucleation efficiency was higher in ThuLEP (1 vs 0.76 gm/min, p= 0.001) but GreenLEP was associated with less haemoglobin deficit than ThuLEP (0.8 vs 1.2 gm/dl, p= .026). The mean ±SD percent reduction of PSA level was 87.7 ±35 % and 79.5 +20.6%, P=0.54) in ThuVEP and GreenLEP groups, respectively (table1). Two patients in each group suffered persistent stress incontinence. CONCLUSIONS: Both ThuLEP and GreenLEP provide comparable relief of lower urinary tract symptoms. Enucletion efficiency was significantly higher in ThuLEP group while hemoglobin deficit was significantly lower in GreenLEP group.Source of Funding: none