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Benign Prostatic Hyperplasia (BPH)NCT07627178

A Prospective Comparative Study Evaluating the Safety and Efficacy of Transurethral Thulium Fiber Laser, Holmium Laser and Bipolar Enucleation of Large Sized Prostate

A study testing Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP), Holmium Laser Enucleation of the Prostate (HoLEP) and Bipolar Transurethral Enucleation of the Prostate (B-TUEP) in people with Benign Prostatic Hyperplasia (BPH) and Lower Urinary Tract Symptom, run by Tanta University at 1 site in Egypt.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This study compares the safety and efficacy of three endoscopic enucleation techniques for large prostates (>100 mL) in patients with benign prostatic hyperplasia (BPH): Thulium Fiber Laser Enucleation (ThuFLEP), Holmium Laser Enucleation (HoLEP), and Bipolar Enucleation (B-TUEP). Read more about this study

Who is it for?
Any age, men onlyHealthy volunteers can take part
What is being tested?
Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP), Holmium Laser Enucleation of the Prostate (HoLEP) and Bipolar Transurethral Enucleation of the Prostate (B-TUEP)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
90 participants
Where
1 siteEgypt
Study dates
21 Oct 2025to 30 May 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • Men only
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Male patients diagnosed with BPH
  • Clinical diagnosis of BPH with lower urinary tract symptoms.
  • IPSS ≥ 20 (severe symptoms)
  • Maximum urinary flow rate (Qmax) ≤ 10 mL/s
  • Prostate volume >100 mL (measured by transrectal ultrasound)
  • Failed medical therapy and fit for operation

Who cannot join

  • Prostate cancer (current or history).
  • Previous prostate surgery
  • Previous urethral surgery.
  • Neurogenic bladder dysfunction.
  • Active urinary tract infection.
  • Severe cardiovascular disease (ASA Class IV).
Show all 9Show fewer
  • Previous pelvic radiation.
  • Urethral stricture
  • Urinary bladder stones.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Abdullah Salah Al Debeiky, MD contact

+201221430915

abdullah.aldebeiky@med.tanta.edu.eg

Omar Khaled Gad, MSc contact

+201117837272

omar_khaled@med.tanta.edu.eg

Egypt1 site, 1 recruiting
  • Tanta University Hospital

    Tanta, Gharbia Governorate, 31111

    Omar Khaled Gad, MSc, +201117837272, omar_khaled@med.tanta.edu.eg

    Abdullah Salah Al Debeiky, MD, +201221430915, abdullah.aldebeiky@med.tanta.edu.eg

    Recruiting

Other trials in Egypt

About this study

This study compares the safety and efficacy of three endoscopic enucleation techniques for large prostates (>100 mL) in patients with benign prostatic hyperplasia (BPH): Thulium Fiber Laser Enucleation (ThuFLEP), Holmium Laser Enucleation (HoLEP), and Bipolar Enucleation (B-TUEP). Ninety male patients with severe lower urinary tract symptoms (IPSS ≥20, Qmax ≤10 mL/s) who failed medical therapy will be randomized 1:1:1 into three groups of 30. Primary outcomes include IPSS, quality of life score, maximum flow rate (Qmax), and post-void residual at 1, 3, and 6 months postoperatively. Secondary outcomes include operative time, enucleation efficiency, blood loss, catheterization duration, hospital stay, and complication rates assessed by the Clavien-Dindo classification.

Read the detailed description

Benign prostatic hyperplasia (BPH) is a progressive condition causing lower urinary tract symptoms (LUTS) that significantly impairs quality of life in aging men. While medical therapy with alpha-blockers and 5-alpha reductase inhibitors represents first-line management, surgical intervention becomes necessary when symptoms are severe or complications arise.

Anatomical endoscopic enucleation of the prostate has emerged as the size-independent gold standard surgical approach. This prospective randomized controlled trial will be conducted at the Urology Department, Tanta University Hospital (October 2025 - October 2027) following IRB approval (Code: 36265MD479/10/25).

Patients will undergo preoperative evaluation including IPSS, QoL index, IIEF-5, uroflowmetry, transrectal ultrasound, PSA, CBC, coagulation profile, and renal/liver function tests. Intraoperative data will include total operative time, enucleation time, morcellation time, enucleation efficiency (g/min), and estimated blood loss. Postoperative follow-up at 1, 3, and 6 months will assess IPSS, QoL, IIEF-5, Qmax, and post-void residual. Complications will be graded using the Clavien-Dindo classification. Randomization will use the sealed opaque envelope method with 1:1:1 allocation.

Being tested
Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP), Holmium Laser Enucleation of the Prostate (HoLEP), Bipolar Transurethral Enucleation of the Prostate (B-TUEP)
Keywords
Prostate Enucleation, ThuLEP, HOLEP, Bi-TUEP, TFL, BPH Surgery, IPSS, Uroflowmetry
Medical subject headings
Prostatic Hyperplasia, Lower Urinary Tract Symptoms, Urinary Bladder Neck Obstruction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP)Procedure or surgery

    Anatomical endoscopic enucleation of the prostate performed transurethrally using a Quanta thulium fiber laser at 60 watts with a 550 μm thulium fiber. Enucleated tissue was removed using a morcellator.

  • Holmium Laser Enucleation of the Prostate (HoLEP)Procedure or surgery

    Anatomical endoscopic enucleation of the prostate performed transurethrally using a Quanta holmium YAG laser at 150 watts with a 550 μm holmium fiber. Enucleated tissue was removed using a morcellator.

  • Bipolar Transurethral Enucleation of the Prostate (B-TUEP)Procedure or surgery

    Anatomical endoscopic enucleation of the prostate performed transurethrally using standard bipolar electrical energy. Enucleated tissue was removed using a morcellator.

Study groups in NCT07627178
Study groupRoleWhat they receive
ThuFLEP GroupActive comparator30 patients undergoing Thulium Fiber Laser Enucleation of the Prostate using Quanta 60W with 550nm Thulium fiber
Receives: Procedure: Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP)
HoLEP GroupActive comparator30 patients undergoing Holmium Laser Enucleation of the Prostate using Quanta 150W with 550nm Holmium YAG fiber
Receives: Procedure: Holmium Laser Enucleation of the Prostate (HoLEP)
Bipolar Enucleation GroupActive comparator30 patients undergoing Bipolar Transurethral Enucleation of the Prostate using standard bipolar energy
Receives: Procedure: Bipolar Transurethral Enucleation of the Prostate (B-TUEP)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. International Prostate Symptom Score (IPSS)

    Change from baseline in IPSS total score (0-35 scale; higher scores indicate worse urinary symptoms). Scores compared across ThuFLEP, HoLEP, and bipolar enucleation groups.

    Measured: at 1, 3 and 6 months post-surgery

  2. Quality of Life Score (QoL)

    Change from baseline in the IPSS-linked Quality of Life index (0-6 scale; higher scores indicate worse quality of life due to urinary symptoms).

    Measured: Baseline and at 1, 3, and 6 months post-surgery

  3. Maximum Urinary Flow Rate (Qmax)

    Change from baseline in maximum urinary flow rate in mL/s as measured by uroflowmetry. Higher values indicate better voiding function.

    Measured: Baseline and at 1, 3, and 6 months post-surgery

  4. Post-Void Residual Urine Volume (PVR)

    Change from baseline in post-void residual urine volume in mL as measured by transabdominal ultrasound. Lower values indicate better bladder emptying.

    Measured: Baseline and at 1, 3, and 6 months post-surgery

Secondary outcomes (7)
  1. Total Operative Time in Minutes

    Total surgical time from start of procedure to completion, including enucleation and morcellation phases.

    Measured: Intraoperative

  2. Enucleation Efficiency in Grams per Minute

    Weight of enucleated prostatic tissue (grams) divided by enucleation time (minutes), reflecting surgical speed and effectiveness.

    Measured: Intraoperative

  3. Estimated Blood Loss as Change in Hemoglobin Level

    Difference between preoperative and 24-hour postoperative serum hemoglobin levels (g/dL). Greater decrease indicates more blood loss.

    Measured: Baseline and 24 hours postoperatively

  4. Catheterization Duration in Days

    Number of days from end of surgery until urethral catheter removal, based on resolution of hematuria and clinical assessment.

    Measured: Up to 7 days postoperatively

  5. Length of Hospital Stay in Days

    Total number of days from surgery to hospital discharge.

    Measured: Up to 7 days postoperatively

  6. Number of Participants with Postoperative Complications as Assessed by Clavien-Dindo Classification

    Rate and severity of complications including urinary incontinence, urinary tract infection, urethral stricture, and need for reoperation, graded using the Clavien-Dindo classification system (Grade I-V; higher grade indicates more severe complication).

    Measured: Up to 6 months postoperatively

  7. Erectile Function Score (IIEF-5)

    Change from baseline in International Index of Erectile Function-5 (IIEF-5) questionnaire score (range 5-25; higher scores indicate better erectile function).

    Measured: Baseline and at 1, 3, and 6 months postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Jun 2026
  2. Study start21 Oct 2025
  3. Primary completion30 Nov 2026 (estimated)
  4. Study completion30 May 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
90 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07627178
Sponsor's protocol ID
36265MD479/10/25
Status last verified
Oct 2025
First submitted
26 May 2026
Last updated
5 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data underlying published results will be shared after de-identification, including data for primary and secondary outcome measures. Data will be available upon reasonable request to the corresponding author following publication.

Publications

  • Giulianelli R, Gentile BC, Mirabile G, Tema G, Nacchia A, Albanesi L, Tariciotti P, Mavilla L, Bellangino M, Lopes Mendes L, Rizzo G, Aloisi P, Vincenti G, Lombardo R. Bipolar Plasma Enucleation of the Prostate: 5 Years Outcomes. J Endourol. 2019 May;33(5):396-399. doi: 10.1089/end.2019.0050.

    PubMed 30816063
  • Chen YY, Hua WX, Huang YH, Shen XY, You JN, Ding X. The safety and efficacy of five surgical treatments in prostate enucleation: a network meta-analysis. BMC Urol. 2024 Jun 17;24(1):128. doi: 10.1186/s12894-024-01517-5.

    PubMed 38886739
  • Kosiba M, Filzmayer M, Welte MN, Hugenell L, Keller AC, Traumann MI, Muller MJ, Kluth LA, Mandel PC, Chun FK, Becker A. Thulium fiber laser vs. holmium laser enucleation of the prostate: results of a prospective randomized non-inferiority trial. World J Urol. 2024 Jan 20;42(1):49. doi: 10.1007/s00345-023-04748-7.

    PubMed 38244076
  • Herrmann TRW, Gravas S, de la Rosette JJ, Wolters M, Anastasiadis AG, Giannakis I. Lasers in Transurethral Enucleation of the Prostate-Do We Really Need Them. J Clin Med. 2020 May 10;9(5):1412. doi: 10.3390/jcm9051412.

    PubMed 32397634
  • Shoma AM, Ghobrial FK, El-Tabey N, El-Hefnawy AS, El-Kappany HA. A randomized trial of holmium laser vs thulium laser vs bipolar enucleation of large prostate glands. BJU Int. 2023 Dec;132(6):686-695. doi: 10.1111/bju.16174. Epub 2023 Sep 28.

    PubMed 37667842

Questions about this trial

What is this clinical trial studying?

A study testing Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP), Holmium Laser Enucleation of the Prostate (HoLEP) and Bipolar Transurethral Enucleation of the Prostate (B-TUEP) in people with Benign Prostatic Hyperplasia (BPH) and Lower Urinary Tract Symptom, run by Tanta University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 5 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Abdullah Salah Al Debeiky, MD (+201221430915, abdullah.aldebeiky@med.tanta.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

International Prostate Symptom Score (IPSS) (time frame: at 1, 3 and 6 months post-surgery). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07627178, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jun 2026.

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