Introduction: We aimed to compare the efficacy and safety of the thulium fiber laser (TFL) vs. MOSES^TM technology for endoscopic enucleation of the prostate in men with benign prostatic hyperplasia. 

Methods: We retrospectively reviewed prospectively collected data of patients who underwent transurethral enucleation of the prostate by a single surgeon using MOSES or TFL technologies from August 2020 to September 2021. Preoperative and intraoperative profiles, as well as postoperative outcomes, were compared. Statistical analyses were performed using JMP Pro^®16 software.

Results: Of the eighty-two patients included in the study, 62 underwent prostate enucleation using MOSES and 20 with TFL technology. There was no significant difference in the preoperative characteristics of both groups. Men who underwent TFL had longer median enucleation time, hemostasis time, and morcellation time (p<0.001) compared to MOSES (Table1). Postoperative functional outcomes, including maximal flow rate, postvoid residual, International Prostate Symptom Score, and quality of life were comparable between both groups at one, three, and six months (Figure 1). Moreover, the incidences of stress incontinence (p=0.97) and urge incontinence (p=0.73), as well as readmission rates (p=0.1) were comparable between the groups.

Conclusions: To the best of our knowledge, this is the first study comparing MOSES and TFL laser technology in prostate enucleation. Both techniques provided a satisfactory safety and efficacy profile, with comparable postoperative outcomes; however, MOSES technology demonstrated superiority in terms of shorter overall operative time.