The Impact of Thulium Laser Enucleation of the Prostate on Urodynamic Parameters and Sexual Function in Patients with Large-Volume Benign Prostatic Hyperplasia

ZHANG Fabiao; LIAO Shangfan; ZHOU Wenhu; LIAN Zhoubiao; ZHU Renwen

doi:10.14033/j.cnki.cfmr.2025.32.017

Abstract：Objective:To explore the effects of thulium laser enucleation of the prostate(ThuLEP)in the treatment of large-volume benign prostatic hyperplasia(BPH)on urodynamic parameters and sexual function of patients,and to compare it with plasma enucleation of the prostate(PKEP).Method:A total of 118 patients with large-volume BPH admitted to the Department of Urology of Sanming First Hospital from February 2022 to January 2025 were selected and randomly divided into the observation group(ThuLEP,n=59)and the control group(PKEP,n=59).The prostate resection volume,surgical enucleation time,bladder irrigation time and indwelling catheterization time of the two groups of patients were compared.Urodynamic indicators[maximum urine flow rate(Qmax),residual urine volume(PVR),bladder compliance(BC)]before and 3 months after the operation,sexual function indicators[International Index of Erectile Function(IIEF-5)and Male Sexual Health Questionnaire-Short Form of Ejaculation Dysfunction(MSHQ-EjD-SF)],International Prostate Symptom Score(IPSS)and record the incidence of complications(urinary incontinence,secondary bleeding,fever,urethral stricture,capsule perforation).Result:The amount of prostate resection in the observation group was greater than that in the control group,while the surgical enucleation time,bladder irrigation time and indwelling catheterization time were all shorter than those in the control group.The differences were statistically significant(P<0.05).Three months after the operation,the levels of Qmax and BC,the scores of IIEF-5 and MSHQ-EjD-SF in the observation group were higher than those in the control group,while PVR and IPSS were lower than those in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications within 3 months after surgery between the two groups(P>0.05).Conclusion:Compared with PKEP,ThuLEP has more advantages in improving surgical efficiency,enhancing urodynamic parameters,and reducing sexual function impairment in the treatment of large-volume BPH,and its safety is comparable.It can be used as the preferred surgical method in clinical practice.