For over a century, transurethral resection of the prostate (TURP) has been the standard surgical technique for prostates measuring 30–80 mL, while open prostatectomy has been the standard for prostates larger than 80 mL. However, in recent decades, anatomical endoscopic enucleation of the prostate (AEEP) has gained increasing recognition and is emerging as a potential alternative to traditional surgical techniques for the treatment of benign prostatic enlargement (BPE), regardless of prostate volume. In Vietnam, AEEP has been introduced in several urology centers. However, most AEEP procedures currently utilize holmium laser or bipolar enucleation, as these energy sources have been widely available in hospitals due to prior investments in kidney and ureteral stone lithotripsy and transurethral prostate resection. This study represents one of the first investigations into the application of thulium laser enucleation of the prostate (ThuLEP) in Vietnam.

This prospective, cross-sectional study was conducted at Military Hospital 175 from September 2023 to December 2024 on 92 patients diagnosed with BPH. Data were collected on preoperative and postoperative clinical symptoms, urinary function (International Prostate Symptom Score [IPSS] and maximum urinary flow rate [Qmax]), anatomical outcomes (prostate volume), and quality of life (QoL). Comparative analyses were performed, and results were benchmarked against international literature.

A total of 92 patients with a mean prostate volume of 72.48 ml were included. All patients (100%) successfully underwent En-Bloc ThuLEP. The average operative time was 84.46 minutes, and the mean hemoglobin concentration decreased by 1.06 g/dL. The mean catheterization time was 2.46 days, and the mean hospital stay was 3.51 days. The average residual prostate volume was 25.47 ml. The overall complication rate was 11.96%.

ThuLEP demonstrates excellent safety and efficacy in managing BPH, offering significant symptom relief, functional improvements, and favorable anatomical outcomes. These findings position ThuLEP as a promising standard surgical technique for BPH, particularly in patients with large prostate volumes.