[Clinical efficacy and safety of a modified transurethral diode laser four-troughs vaporesection in treating benign...

To investigate the efficacy and safety of a modified transurethral diode laser four-troughs vaporesection in treating benign prostatic hyperplasia (BPH). The clinical data of BPH patients who underwent prostatic surgery between January 2023 and June 2025 at Guangdong Provincial People's Hospital, Southern Medical University were retrospectively included. The patients were divided into two groups according to the surgical methods: the four-troughs group (patients who underwent modified four-troughs vaporesection of the prostate using a 1 470 nm diode laser), and the enucleation group (patients who underwent 1 470 nm diode laser enucleation of the prostate). The patients were followed up to 6 months after surgery. Independent sample t test, Mann-Whitney U test and analysis of covariance were used to compare perioperative related indicators between the two groups, including prostate volume, International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum urinary flow rate (Q_max), post-void residual urine volume (PVR), duration of surgery, hemoglobin drop level, length of hospital stay, bladder irrigation time and postoperative complications. A total of 103 male patients, aged of (70±6) years, were included. Fifty-five patients were included in the four-troughs group and 48 patients in the enucleation group. The follow-up duration [M (Q₁, Q₃)] was 3 (2, 5) months. The operative time [(109±36) vs (124±35) min, P=0.024] and hospital stay [(9.4±3.6) vs (11.5±3.4) days, P=0.010], hemoglobin drop level [(6.6±7.8) vs (11.7±8.3) g/L, P=0.002] of the four-troughs group were lower than those of the enucleation group. There were no statistically significant differences in prostate volume, Q_max, PVR, preoperative or postoperative IPSS and QoL between the two groups. (all P>0.05). A total of 5 patients developed mild postoperative complications (2 in the four-troughs group and 3 in the enucleation group), and all improved after symptomatic treatment. The modified transurethral 1 470 nm diode laser four-troughs vaporesection is easy to operate, which is associated with less reduction in hemoglobin level and a shorter operative time. Its short-term therapeutic efficacy and safety are comparable to those of enucleation.