The ThuLEP Technique: Prostate Surgery With Thulium Laser

Prostate surgery with thulium laser, that is the ThuLEP technique, is one of the most current treatment options used in the treatment of benign prostatic hyperplasia. In the application of the ThuLEP technique, continuous laser technology is used.

The prostate is an organ located at the bladder outlet in male individuals, through which the urinary channel passes. The prostate is an organ that grows in size along with ageing. The enlarged prostate compresses the urinary channel passing through it and causes urinary problems to be experienced.

Enlargement in the prostate that is not due to cancer cells is called benign prostatic hyperplasia (BPH). When choosing the treatment method for benign prostatic hyperplasia, the decision is made according to the size of the prostate. Now, in the treatment of prostate enlargement, laser methods that develop a little more with each passing day are being applied and patients are enabled to lead a comfortable life.

Obtain detailed information about HoLEP, another laser treatment technique in the treatment of benign prostatic hyperplasia.

What Is Prostate Surgery With the ThuLEP Technique?

In resection operations applied with electrical energy for benign prostatic hyperplasia (BPH), long-lasting burning on urination (dysuria), bleeding and hospital stay could frequently be seen.

However, today, with the two types of laser frequently preferred, holmium and thulium, whatever the size of the prostate, the enlarged prostate tissue can be eliminated entirely endoscopically by entering through the urinary channel with the aid of a camera and laser.

The use of laser technology in surgical methods in the field of health also brings with it many advantages. In the recommendations of the European and American Urological Associations there is also a clear consensus on the fact that laser enucleation of the prostate can be applied safely and successfully in a prostate of any size.

In the historical development of laser methods we see clearly in the literature that the thulium laser, presented after the holmium laser, has a lower depth of tissue penetration (0.4 mm for holmium, and 0.25 mm for thulium), that even though their wavelengths are similar the holmium laser creates a sudden rise in heat with pulsed energy and provides cooling between its pulses, whereas with the thulium laser, working steadily at a specific temperature with continuous energy, tissue and cell damage is less - this is clearly stated in the literature from a technical point of view.

The Advantages the ThuLEP Technique Provides for the Patient

In ThuLEP surgery, in which the thulium laser is used, similarly the enlarged prostate tissues are cut from inside the urinary channel and the urinary channel is opened as far as the prostate capsule.

In general, although the surgical results carried out with both laser energies are gratifying to a similar degree, in recent studies, due to the technical differences of the laser energies, better cutting power, less bleeding, a shorter hospital stay and faster recovery times are mentioned with thulium.

Although it is known that the sphincter muscle tissue in the urinary channel that allows us to hold urine can be adequately preserved with both laser methods, the thulium laser energy cutting the surrounding tissues more easily lowers the risk of any strain or damage in this area even further.

Furthermore, the prostate tissue separating with difficulty from the capsule due to past inflammations of the prostate, and the presence of vascular structures feeding the prostate just behind the capsule, support the fact that the surgical procedure can be applied more easily with the thulium laser in experienced hands. In both surgical methods the average duration of catheterisation is 1-2 days and patients can be discharged within as short a period as around 24 hours on average.

Sexual functions not being affected, the elimination of difficulty in urinating that disrupts the quality of daily life, and its applicability even in patients receiving blood-thinning (anticoagulant) treatment because of additional diseases can also be listed as its other main advantages.

How Is Thulium (ThuLEP) Surgery Performed?

Laser surgery with the ThuLEP technique lasts on average between 1-3 hours depending on the patient's prostate volume. The length of hospital stay after the operation likewise depends on the size of the prostate. In addition to this, the patient's age and the patient's additional diseases are also effective in lengthening or shortening this process.

In ThuLEP surgery performed using the thulium laser, entry is made through the external urinary opening (urethral meatus), progress is made along the urinary channel (urethra) and the abnormally enlarged prostate tissue is reached.

The broken-up prostate tissues are pushed into the bladder. These particles are then pulled out through the urinary channel with a device called a morcellator.

In prostate surgery carried out with the thulium laser, thanks to the physical properties of the laser, less tissue and cell damage occurs.

In laser enucleation methods such as ThuLEP, because the prostate tissue is completely removed from the prostate capsule, complaints of prostate enlargement do not recur for many years. After the operation, burning on urination (dysuria) or bleeding is generally not expected.