Related Experiment Video
Updated: Jan 18, 2026
Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser
Published on: May 5, 2020
[Minimally invasive enucleation of the prostate (MiLEP) with thulium fiber laser: preliminary results]
S Petov V1,2,3, M Dymov A1,2,3, R Azilgareeva1,2,3
1Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia of the Ministry of Health of Russia, Moscow, Russia.
Introduction:
Endoscopic enucleation of the prostate is the standard surgical treatment for patients with BPH >80 cc. Despite its efficiency, the incidence of stress urinary incontinence (<6 months) and urethral stricture remains significant at 16.6-29.4% and 1.7-6.5%, respectively. The use of smaller instruments can potentially reduce the rates of these complications.
Aim:
This study aims to evaluate the efficiency and safety of minimally invasive laser enucleation of the prostate (MiLEP) using a thulium fiber laser (TFL).
Materials And Methods:
A prospective study was initiated in March 2024. The inclusion criteria were severe lower urinary tract symptoms (IPSS >20) and/or Qmax <15 ml/s or the necessity for bladder drainage. MiLEP was performed using 22 Ch resectoscope and TFL FIBERLASE U1 and FIBERLASE U-MAX (NTO IRE-Polus, Russia) with the following settings: 1.5 J and 50-55 Hz and 1.7-2 J and 40-45 Hz (DissectPulse). MiLEP technique was en bloc no-touch enucleation with early apical release. Peri- and early postoperative outcomes and complication rates were assessed.
Results:
MiLEP was performed in 15 patients with a median age of 67 years (IQR 62.5; 69.5), prostate volume of 61 cc (IQR 46.5; 65.5), and IPSS score was 25.5 (IQR 23.3; 27), Qmax was 5.3 ml/s (IQR 4.5; 9.3). The median duration of the procedure was 42 min (IQR 37; 55), enucleation was 25 min (IQR 21; 28), and morcellation was 7.5 min (IQR 4; 8). Enucleation efficiency was 1.2 g/min (IQR 1; 1.5) and morcellation efficiency was 5.3 g/min (IQR 4.6; 7.7). The median hemoglobin drop was 6.5 g/l (IQR 1.5; 12.8) and the mass of removed tissue was 34 g (IQR 25; 42). The median catheterization and hospitalization time were 2 days (IQR 2; 2.8) and 3 days (IQR 3; 6), respectively. After 1 month, the median IPSS score was 5 (IQR 4; 6; < 0.001), Qmax was 18.7 ml/s (IQR 18; 21; < 0.001). Complications were observed in 5 (33.3%) patients (grade I according to Clavien-Dindo). Stress urinary incontinence occurred in 2 (13.3%) patients on the first day after catheter removal, but in none at 1 month after MiLEP.
Conclusion:
Minimally invasive enucleation of the prostate with a thulium fiber laser can be considered an effective and safe surgical treatment option for patients with BPH.
