Thulium Fiber Laser Enucleation of the Prostate (TFLEP) vs HoLEP With Moses Technology (m-HoLEP)
Benign Prostatic Hyperplasia
About this trial
This is an interventional treatment trial for Benign Prostatic Hyperplasia focused on measuring Lasers, Solid-State, Lower Urinary Tract Symptoms, Hyperplasia, Urological Manifestations, Prostatic Disease
Eligibility Criteria
Inclusion Criteria:
- Patients with symptomatic benign prostate hyperplasia : urinary retention, acute renal failure (post-renal), refractory hematuria, repeated urinary tract infections, refractory symptoms.
- Prostates between 50-300 grams,
- IPSS ≥ 8,
- Inadequate response to previous medical treatments,
- Qmax < 15 ml/sec and
- Providing informed consent
Exclusion Criteria:
- History of prostatic surgery,
- History of prostate or bladder cancer,
- Neurogenic bladder,
- Urethral stricture,
- Anticoagulant therapy (aspirin permitted), not ceased during surgery
- Patients unfit for surgery
Sites / Locations
- Centre hospitalier de l'Université de MontréalRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
TFLEP
m-HoLEP
Thulium fiber laser (TFL) is a novel laser technology that delivers a pulsed laser at a more optimal wavelength and a shallower depth of tissue penetration leading to better hemostatic properties. Patients will undergo thulium fiber laser enucleation of the prostate (TFLEP) at the Centre Hospitalier de l'Université de Montréal (CHUM) as a treatment for benign prostate hyperplasia. The surgeon performing TFLEP is experienced in TFLEP procedures.
The holmium: yttrium-aluminum-garnet (Ho: YAG) laser is the longest running and most studied laser used to perform this minimally invasive procedure. Holmium laser enucleation of the prostate reduces hospital stay and hemoglobin drop while improving IPSS and quality of life, as well as other positive postoperative outcomes compared to the historical gold standard, transurethral resection of the prostate (TURP). HoLEP has been found to have a better enucleation efficiency rate and may have better hemostatic properties when combined with the modulated pulsed laser energy featured associated with Moses technology (m-HoLEP). Patients will undergo m-HoLEP at the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal as a treatment for benign prostate hyperplasia. The surgeon performing m-HoLEP is experienced in m-HoLEP procedures.