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Bulai CA, Multescu RD, Geavlete PA, Punga AMA, Militaru A, Buzescu BG, Ene CV, Mares C, Geavlete BF. The Impact of Transurethral Enucleation Therapeutic Approach in All-Size Benign Prostatic Obstruction Pathology: From Contemporary Technological Advances to Evidence-Based Clinical Progresses. Diagnostics (Basel) 2025; 15:416. [PMID: 40002567 PMCID: PMC11854753 DOI: 10.3390/diagnostics15040416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 01/22/2025] [Accepted: 02/06/2025] [Indexed: 02/27/2025] Open
Abstract
Transurethral enucleation (TUE) has revolutionized the management of benign prostatic obstruction (BPO), offering a minimally invasive solution with superior efficacy across all prostate sizes. This review explores the advancements in TUE techniques, including Holmium Laser Enucleation of the Prostate (HoLEP), Thulium Laser Enucleation of the Prostate (ThuLEP), and bipolar enucleation, highlighting their clinical benefits, safety profiles, and long-term outcomes. Compared to traditional approaches such as transurethral resection of the prostate (TURP) and open prostatectomy, TUE has been associated with reduced complication rates, shorter recovery times, and durable symptom relief. The manuscript also examines patient-centered considerations, such as quality of life improvements and preservation of sexual function, which contribute to high patient satisfaction. Furthermore, the economic advantages of TUE, driven by reduced retreatment rates and healthcare costs, underscore its value for both patients and healthcare systems. Emerging innovations, including artificial intelligence (AI), promise to further enhance procedural planning, surgical precision, and training pathways. Efforts to expand global access through cost-effective adaptations like bipolar enucleation and targeted training initiatives are paving the way for wider adoption of TUE. With its adaptability, technological advancements, and focus on patient outcomes, TUE is poised to become the global standard of care in BPO management.
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Affiliation(s)
- Catalin-Andrei Bulai
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Razvan-Dragos Multescu
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Petrisor-Aurelian Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Ana Maria Andreea Punga
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Adrian Militaru
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Bogdan-Gabriel Buzescu
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Cosmin-Victor Ene
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Cristian Mares
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
| | - Bogdan-Florin Geavlete
- Department of Urology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.-A.B.); (A.M.A.P.); (A.M.); (B.-G.B.); (C.-V.E.); (C.M.); (B.-F.G.)
- Department of Urology, “Saint John” Clinical Emergency Hospital, 042122 Bucharest, Romania
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Puliyath N, Venugopalan AV, Das Kv S, Parol S. The thermal effect of lasers in urology: a review article. Lasers Med Sci 2023; 39:6. [PMID: 38093121 DOI: 10.1007/s10103-023-03948-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023]
Abstract
Lasers as a technology have a leading role in the modern urological treatment armamentarium. In this article, the application of lasers in different areas of urology is described. The major uses are in urolithiasis, benign prostatic enlargement (BPE), and management of many urological malignancies and other benign pathologies. Lasers have become an established treatment modality in urolithiasis, an acceptable alternative with the least side effect profile in BPE patients, and a novel and promising therapy in many other fields of Urology.
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Affiliation(s)
- Nisanth Puliyath
- Department of Urology & Renal Transplant Surgery, Government Medical College, Kozhikode, India.
| | - A V Venugopalan
- Department of Urology & Renal Transplant Surgery, Government Medical College, Kozhikode, India
| | - Shanmugha Das Kv
- Department of Urology & Renal Transplant Surgery, Government Medical College, Kozhikode, India
| | - Subeesh Parol
- Department of Urology & Renal Transplant Surgery, Government Medical College, Kozhikode, India
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