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29.07.2023 | Topic Paper

Holmium laser with MOSES technology (MoLEP) vs Thulium fiber laser enucleation of the prostate (ThuFLEP) in a real-world setting. Mid-term outcomes from a multicenter propensity score analysis

verfasst von: Daniele Castellani, Mirko Di Rosa, Fernando Gómez Sancha, Moisés Rodríguez Socarrás, Abhay Mahajan, Mohammed Taif Bendigeri, Mark Taratkin, Dmitry Enikeev, Marco Dellabella, Nariman Gadzhiev, Bhaskar Kumar Somani, Thomas R. W. Herrmann, Vineet Gauhar

Erschienen in: World Journal of Urology | Ausgabe 11/2023

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Abstract

Purpose

To compare Holmium laser with MOSES technology (MoLEP) and Thulium fiber laser enucleation of the prostate (ThuFLEP) in terms of surgical and functional outcomes.

Methods

We performed a retrospective analysis of all patients who underwent either procedure in five centers (January 2020–January 2022). Exclusion criteria: previous urethral/prostatic surgery, radiotherapy, concomitant surgery. Propensity score matching (PSM) analysis was performed to adjust for the bias inherent to the different characteristics at baseline. Differences between procedures were estimated using Firth Penalized Likelihood regression for International prostate symptom score (IPSS), quality of life (QL), maximum flow rate (Qmax).

Results

PSM retrieved 118 patients in each group. Baseline characteristics were similar except for PSA and number of men on indwelling catheter (higher in MoLEP group). Median surgical time was significantly longer in the MoLEP group despite the enucleation and morcellation times being similar. Median catheter dwelling time and postoperative length of stay were similar. Most of the early complications were Clavien ≤ 2 grade. There were only two Clavien grade 3 complications (one for each group), one grade 4 in MoLEP group. Rate and type of early and persistent incontinence (> 3 months) were similar. At 12-month, proportion of patients reaching a decrease (Δ) of IPSS ≥ 18 from baseline was significantly larger in MoLEP group, with no significant difference in ΔQmax > 12 ml/sec and ΔQL ≥ -3.

Conclusion

MoLEP and ThuFLEP were safe and efficacious procedures with similar short-term operative and functional outcomes. At 1-year, MoLEP patients had a sustained reduction of IPPS score.

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Titel: Holmium laser with MOSES technology (MoLEP) vs Thulium fiber laser enucleation of the prostate (ThuFLEP) in a real-world setting. Mid-term outcomes from a multicenter propensity score analysis
verfasst von: Daniele Castellani
Mirko Di Rosa
Fernando Gómez Sancha
Moisés Rodríguez Socarrás
Abhay Mahajan
Mohammed Taif Bendigeri
Mark Taratkin
Dmitry Enikeev
Marco Dellabella
Nariman Gadzhiev
Bhaskar Kumar Somani
Thomas R. W. Herrmann
Vineet Gauhar
Publikationsdatum: 29.07.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 11/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04524-7

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Holmium laser with MOSES technology (MoLEP) vs Thulium fiber laser enucleation of the prostate (ThuFLEP) in a real-world setting. Mid-term outcomes from a multicenter propensity score analysis