Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients

Objective:We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate(ThuVEP)for treatment of obese patients affected by benign prostatic hyperplasia(BPH).Methods:We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single center.Patients were divided into three groups according to body mass index(BMI,kg/m^2):Normal weight(18.5≤BMI<25;Group A),overweight(25≤BMI<30;Group B)and obese(BMI≤30;Group C),for a total of 412 patients evaluable for this study.Preoperative total serum prostate-specific antigen(PSA),digital rectal examination of the prostate,transrectal ultrasound(TRUS),renal ultrasound,urine culture,uroflowmetry,International Prostate Symptoms Score(IPSS),and Quality of Life(QoL)score were analyzed.Post-operative complications,hospital stay and days of catheterization,questionnaires and uroflowmetry at 1 and 3 months after surgery were evaluated.Preoperative data,surgical outcomes,complication rate and clinical outcomes were compared between groups.Results:The median age of patients was 69 years(Interquartile Range[IQR 10]).The preoperative median IPSS among groups was 19(IQR 8.75),20(IQR 10),and 18(IQR 10)respectively.At 1 and 3 months of follow-up,this value was 8(IQR 7),8(IQR 4),7(IQR 5)and 5(IQR 6.25),5(IQR 6),6(IQR 5),respectively(all p between groups>0.05).There was no statistically significant difference among three groups as for hospital stay and days of catheterization(p>0.05).Conclusion:Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.