Comparative efficacy of 450 nm blue-laser vaporization versus transurethral plasma kinetic enucleation of the prostate (TUPKEP) for benign prostatic hyperplasia in high-risk elderly patients: a focus on safety, efficacy, and sexual function preservation.

OBJECTIVE

To explore the clinical efficacy, safety, and potential value for preserving sexual function of the 450 nm advanced blue-laser device in the treatment of high - risk and elderly patients with benign prostatic hyperplasia (BPH).

METHODS

Analysis was conducted on 161 elderly and high-risk patients with BPH who underwent surgical treatment. They were divided into the blue-lasergroup (77 cases) and the Transurethral Plasma Kinetic Enucleation of the Prostate (TUPKEP) (84 cases). The general data of the patients in both groups were collected, including age, TPSA, prostate volume, and comorbidities. Subsequently, intraoperative and postoperative indicators of the two groups were compared, including Qmax, IPSS, QoL scores before and after treatment, and complications.

RESULTS

The perioperative indicators of the patients in the 450 nm blue-lasergroup, namely the operation time and intraoperative blood loss, were 40.70 ± 15.44 min and 22.74 ± 19.98 ml, respectively, which were significantly lower than those of the TUPKEP group (81.61 ± 33.50 min and 65.45 ± 70.87 ml). The overall incidence of complications in the TUPKEP group was higher than that in the 450 nm blue-laser group, mainly manifested in transient urinary incontinence, sexual function, etc. The IIEF-5 score of the laser group at 3 months after surgery was significantly higher than that of the plasma enucleation group (17.04 ± 2.01). There was no significant difference in the comparison of Qmax, IPSS score, and QoL between the two groups at 3 months after surgery (P > 0.05).

CONCLUSION

The 450 nm blue-laser vaporization for the treatment of high-risk BPH has advantages such as convenient operation, definite curative effect, and fewer complications.