Optimal Duration of Urethral Catheterization in ThuLEP: A Randomized Prospective Pilot Study

Area of Science:

• Urology
• Minimally Invasive Surgery
• Benign Prostatic Hyperplasia Management

Background:

• Lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO) are prevalent in aging men.
• Transurethral resection of the prostate (TURP) and laser enucleations (HoLEP, ThuLEP) are established treatments.
• Thulium laser enucleation (ThuLEP) offers potential advantages over TURP, including reduced bleeding and shorter catheterization.

Purpose of the Study:

• To compare the outcomes of 24-hour versus 72-hour postoperative catheterization following Thulium laser enucleation (ThuLEP).
• To assess voiding dynamics (Qmax) and patient-reported outcomes.
• To generate preliminary data for future confirmatory trials on early catheter removal after ThuLEP.

Main Methods:

• A randomized prospective pilot study involving 42 patients undergoing ThuLEP.
• Patients were assigned to either 24-hour (Group 1) or 72-hour (Group 2) catheter removal.
• Outcomes measured included uroflowmetry (Qmax), validated questionnaires (SF-36, ICIQ-SF, IPSS), and complication rates.

Main Results:

• No clinically significant differences in voiding dynamics or patient-reported outcomes were observed between the 24-hour and 72-hour groups.
• The 24-hour group experienced fewer postoperative complications (1 case) compared to the 72-hour group (6 cases), including urinary leakage, hematuria, and acute urinary retention.

Conclusions:

• Early catheter removal at 24 hours post-ThuLEP is feasible and yields comparable urinary function and patient-reported outcomes to the standard 72-hour protocol.
• These findings support the safety and efficacy of early catheter removal, warranting further investigation in larger trials.