The ‘Three-Groove and Two-Arc’ technique for modified Thulium laser enucleation of the prostate: a retrospective study on efficacy and safety

Purpose To investigate the efficacy, safety, and urinary continence outcomes of the ‘Three-Groove and Two-Arc’ modified ThuLEP technique for the treatment of large prostate. Methods This retrospective study included 1,325 patients with benign prostatic hyperplasia (BPH) who underwent surgery at our center. Parameters were measured before and after the procedure: prostate-specific antigen (PSA), prostate volume, International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), and post-void residual urine (PVR). Additionally, enucleation time, morcellation time, operation time, catheterization time, and presence of transient urinary incontinence were recorded. Follow-up assessments of IPSS, Qmax, and PVR were conducted 1, 3, and 6 months after the operation. Results The mean age of the patients was 73.2 ± 10.4 years. The mean prostate volume was 115.6 ± 24.5 mL, and the mean PSA was 3.8 ± 1.4 ng/mL. The mean preoperative IPSS was 28.5 ± 3.7, which decreased to 11.6 ± 2.8 at one month postoperatively. The mean preoperative PVR was 88.2 ± 43.5 mL, compared to 29.3 ± 12.3 mL at one month postoperatively. The mean enucleation time was 45.6 ± 9.2 min, and the mean morcellation time was 9.8 ± 2.1 min. Transient urinary incontinence was documented in 65 patients (4.9%). Conclusion The “Three-Groove and Two-Arc” technique showed a favorable safety profile and early functional outcomes in patients with large-volume BPH (>80 mL), with a low documented rate of transient urinary incontinence.