Journal of Lasers in Medical Sciences

Abstract

Introduction: Significantly impairs the quality of life through lower urinary tract symptoms. Ejaculation-sparing Thulium laser enucleation, a minimally invasive technique, offers symptom relief while aiming to preserve sexual function. This study aimed to assess the clinical outcomes, safety, and efficacy of thulium laser enucleation of the prostate in Jordan.

Methods: A longitudinal, quantitative study was conducted in three private clinics and three private hospitals in Amman, Jordan. This study included 29 male patients suffering from moderate to severe benign prostatic hyperplasia (BPH). Postoperatively, at intervals of 2, 4, 6, and 8 months following ejaculation-sparing thulium laser enucleation, several instruments were utilized to measure the maximum urinary flow rate, post-void residual (PVR) volume, average flow rate, prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5).

Results: After undergoing ejaculation-sparing thulium laser enucleation, the mean maximum urinary flow rate saw a significant increase from 6.3 ± 2.8 mL/s at baseline to 19.8 ± 3.2 mL/s at 2 months. It then increased to 20.6 ± 3.0 mL/s at 4 months and to 19.0 ± 1.7 mL/s at 8 months (P < 0.001). Furthermore, the average urinary flow rate improved, rising from 4.31 ± 1.8 mL/s to 9.5 ± 4.1 mL/s, then to 16.2 ± 2.8 mL/s, and finally to 12.7 ± 2.9 mL/s at the same intervals (P < 0.001). Symptom severity, as indicated by the IPSS, underwent a significant improvement from 21.33 ± 3.1 to 5.1 ± 3.4 (P < 0.001).

Conclusion: Ejaculation-sparing thulium laser enucleation is an effective and safe treatment for BPH. It offers notable improvements in urinary function and symptom relief, and it also helps to preserve sexual function.