Urethral Stricture with a Miniaturised (22 Fr) Versus Standard (26 Fr) Resectoscope Sheath During Thulium Fibre Laser Enucleation of the Prostate: A Prospective, Two-Centre Comparative Cohort Study
- 1Department of Urology, Medical Faculty, KTO Karatay University, Konya 42100, Turkey
- 2Department of Urology, Konya City Hospital, University of Health Sciences, Konya 42020, Turkey
- 3Department of Urology, Medical Faculty, Necmettin Erbakan University, Konya 42080, Turkey
Abstract
Objectives: We aimed to compare the observed rates of postoperative urethral stricture between patients undergoing thulium fibre laser enucleation of the prostate (ThuFLEP) using a 22 Fr miniaturised instrument strategy and those treated using a standard 26 Fr strategy. Methods: This prospective, two-centre comparative cohort study included 208 patients with benign prostatic hyperplasia and a prostate volume of less than 150 mL who underwent thulium fibre laser enucleation of the prostate (ThuFLEP) between 2024 and 2026. Patients were grouped according to the resectoscope sheath used at each centre: Group 1 comprised 99 patients treated with a 22 Fr miniaturised sheath and Group 2 comprised 109 patients treated with a standard 26 Fr sheath. The primary endpoint was the development of postoperative urethral stricture. Patient demographics and preoperative and postoperative clinical outcomes were also recorded. Results: Demographic and operative parameters were comparable between the groups. No significant difference was observed in mean prostate volumes (68.8 ± 34.1 vs. 70.8 ± 25.7 mL). Although the enucleation efficiency (g/min) was numerically higher in Group 1, the difference did not reach statistical significance (2.2 ± 1.1 vs. 1.8 ± 0.6; p = 0.082). Postoperative urethral stricture was observed in 2 patients (2.0%) in Group 1 and in 10 patients (9.2%) in Group 2. The incidence of stricture was significantly higher in Group 2 (p = 0.036). Conclusions: The 22 Fr ThuFLEP strategy was associated with a lower observed urethral stricture rate. However, the independent effect of sheath diameter could not be separated from centre- and surgeon-related factors. Further randomised studies are required to confirm these findings.
Related
- Association between lateral lobe enucleation time and urethral stricture after Holmium Laser Enucleation of the Prostate (HoLEP): a retrospective cohort study.
- Vitamin D status and lower urinary tract symptoms in children: Findings from a prospective comparative study
- Comparative Evaluation of Concurrent Carboplatin-Paclitaxel Versus Cisplatin-Etoposide Chemoradiotherapy in Unresectable Non-small Cell Lung Cancer: A Prospective Randomized Study
- Anterior Cruciate Ligament (ACL) Reconstruction With Lateral Meniscal Repair With and Without Lateral Extra-articular Tenodesis: A Prospective Comparative Study of Functional and Rotational Outcomes
- Albumin Supplementation Preserves Systemic Antioxidant Defenses in Critically Ill, Septic Patients: A Prospective Comparative Study
BibTeX
@article{buldu2026urethral,
title = {{Urethral Stricture with a Miniaturised (22 Fr) Versus Standard (26 Fr) Resectoscope Sheath During Thulium Fibre Laser Enucleation of the Prostate: A Prospective, Two-Centre Comparative Cohort Study}},
author = {İbrahim Buldu and Mustafa Bilal Hamarat and Burak Yılmaz and Taha Emre Aydın and Hakan Hakkı Taşkapu},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197724},
url = {https://europepmc.org/article/PMC/PMC13666361},
note = {CC BY},
}
RIS
TY - JOUR
TI - Urethral Stricture with a Miniaturised (22 Fr) Versus Standard (26 Fr) Resectoscope Sheath During Thulium Fibre Laser Enucleation of the Prostate: A Prospective, Two-Centre Comparative Cohort Study
AU - İbrahim Buldu
AU - Mustafa Bilal Hamarat
AU - Burak Yılmaz
AU - Taha Emre Aydın
AU - Hakan Hakkı Taşkapu
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197724
UR - https://europepmc.org/article/PMC/PMC13666361
AB - Objectives: We aimed to compare the observed rates of postoperative urethral stricture between patients undergoing thulium fibre laser enucleation of the prostate (ThuFLEP) using a 22 Fr miniaturised instrument strategy and those treated using a standard 26 Fr strategy. Methods: This prospective, two-centre comparative cohort study included 208 patients with benign prostatic hyperplasia and a prostate volume of less than 150 mL who underwent thulium fibre laser enucleation of the prostate (ThuFLEP) between 2024 and 2026. Patients were grouped according to the resectoscope sheath used at each centre: Group 1 comprised 99 patients treated with a 22 Fr miniaturised sheath and Group 2 comprised 109 patients treated with a standard 26 Fr sheath. The primary endpoint was the development of postoperative urethral stricture. Patient demographics and preoperative and postoperative clinical outcomes were also recorded. Results: Demographic and operative parameters were comparable between the groups. No significant difference was observed in mean prostate volumes (68.8 ± 34.1 vs. 70.8 ± 25.7 mL). Although the enucleation efficiency (g/min) was numerically higher in Group 1, the difference did not reach statistical significance (2.2 ± 1.1 vs. 1.8 ± 0.6; p = 0.082). Postoperative urethral stricture was observed in 2 patients (2.0%) in Group 1 and in 10 patients (9.2%) in Group 2. The incidence of stricture was significantly higher in Group 2 (p = 0.036). Conclusions: The 22 Fr ThuFLEP strategy was associated with a lower observed urethral stricture rate. However, the independent effect of sheath diameter could not be separated from centre- and surgeon-related factors. Further randomised studies are required to confirm these findings.
SN - 2077-0383
ER -