En Bloc Thulium Laser Enucleation of the Prostate: Surgical Technique and Advantages Compared With the Classical Technique.

Objective: To report a new technique for thulium laser enucleation of the prostate, which we called "en bloc" ThuLEP.

Methods: A full anatomic description of the technique is provided. We assessed operative variables of a 50-patient series, treated with the new "en bloc" ThuLEP, and compared them with another series of 50 patients (who had the same preoperative parameters) operated with the classical "3-lobe" technique, to assess the feasibility of the new one. All procedures were carried out by the same surgeon.

Results: In our experience, "en bloc" ThuLEP permits an easier enucleation of the adenoma, reduces operating time, and reduces the amount of energy delivered per adenoma gram compared with the classical technique. Further studies are needed to validate this technical evolution of prostatic enucleation and verify the reduction of postoperative irritative symptoms.

Conclusion: "En bloc" ThuLEP may represent a valid alternative for prostatic adenoma enucleation, mostly in medium-sized prostates.