Objective:

To assess the feasibility, including safety and effectiveness, of Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP) using a 365 μm fiber in a diverse patient population.

Key Findings:

• 123 patients with a mean age of 72.4 years and average prostate size of 94.8 g were included, highlighting the demographic diversity.
• Mean operation time was 115 minutes with an average resected tissue volume of 67.9 g, indicating efficiency.
• Peri-operative complications occurred in 18.7% of patients, with bleeding and urinary retention being the most common, suggesting areas for improvement.
• Reoperation was required in 10.6% of patients, primarily due to macrohematuria, emphasizing the need for careful monitoring.
• 16.3% of patients experienced early re-admission post-discharge, which may indicate a need for enhanced post-operative care.

Interpretation:

The use of a 365 μm fiber for ThuFLEP appears feasible and effective in a real-world setting, with manageable complication rates and promising efficiency metrics.

Limitations:

• Retrospective design limits the ability to establish causality, which may affect the reliability of the outcomes.
• Single-center study may not generalize to other populations, limiting the external validity of the findings.
• Lack of recorded enucleation and morcellation times affects efficiency assessment, which could lead to underestimating the procedure's effectiveness.

Conclusion:

ThuFLEP using a 365 μm fiber is a viable option for BPH treatment, demonstrating acceptable safety and efficacy in a diverse patient cohort, with implications for broader clinical application.