A comparative study of thulium fiber laser and holmium:YAG laser for prostate enucleation: a systematic review and meta-analysis
Abstract
Introduction: Laser enucleation has become a preferred surgical treatment for benign prostatic hyperplasia (BPH), especially for large prostates and patients unable to discontinue anticoagulation. This systematic review and meta-analysis compared the efficacy and safety of Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP) and Holmium Laser Enucleation of the Prostate (HoLEP). Methods: We searched PubMed, Scopus, Embase, and the Cochrane Library for studies published up to February 2025. We included randomized controlled trials and observational studies comparing ThuFLEP and HoLEP in adult males with BPH. Outcomes included symptom scores (IPSS), urinary flow (Qmax), quality of life (QoL), post-void residual (PVR), enucleation time, operative time, enucleation efficiency, and complications. Risk of bias was assessed using the Cochrane RoB 2.0 tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. Data were synthesized using random-effects meta-analysis models. Results: Eleven studies were included. IPSS, QoL, PVR, total operative time, and complications showed no significant differences between groups. HoLEP showed a significantly greater Qmax improvement at 3 months (mean difference -1.25 mL/s; 95% CI -1.847 to -0.653) and shorter enucleation time (mean difference 7.654 min; 95% CI 0.362 to 14.947), though the clinical relevance was limited. No significant differences were observed in enucleation efficiency or urinary incontinence rates. Study limitations…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Treatment of non-metastatic castration-resistant prostate cancer: facing age-related comorbidities and drug–drug interactions
- The Efficacy of Flogofilm® in the Treatment of Chronic Bacterial Prostatitis as an Adjuvant to Antibiotic Therapy: A Randomized Prospective Trial
- Inhibition of growth and contraction in human prostate stromal cells by silencing of NUAK1 and -2, and by the presumed NUAK inhibitors HTH01-015 and WZ4003
- Effectiveness and Safety of a New Nutrient Fixed Combination Containing Pollen Extract Plus Teupolioside, in the Management of LUTS in Patients with Benign Prostatic Hypertrophy: A Pilot Study
- Extract from Cucurbita pepo improves BPH symptoms without affecting sexual function: a 24-month noninterventional study
- Aquablation vs. holmium laser enucleation of the prostate for benign prostatic hyperplasia: a 150-patients prospective comparative multicenter study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.