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Thulium Laser Enucleation With Bladder Neck Incision for Small-Volume Benign Prostatic Hyperplasia (ThuLEP-BNI)

29. april 2026 opdateret af: Qing Yuan, Chinese PLA General Hospital

Thulium Laser Enucleation of the Prostate Combined With Bladder Neck Incision for Small-Volume Benign Prostatic Hyperplasia: A Multicentre, Randomized, Single-Blind, Controlled Trial

This study will evaluate the safety and effectiveness of thulium laser enucleation of the prostate combined with bladder neck incision in men with small-volume benign prostatic hyperplasia (BPH). Small-volume BPH may still cause significant bladder outlet obstruction and bothersome lower urinary tract symptoms, and the optimal surgical treatment for these patients remains uncertain.

In this multicenter, randomized, single-blind, controlled trial, 426 eligible men aged 40 to 80 years will be assigned in a 1:1:1 ratio to one of three groups: thulium laser enucleation of the prostate combined with bladder neck incision, thulium laser enucleation alone, or transurethral resection of the prostate. The main goal is to compare the incidence of bladder neck contracture at 6 months after surgery. Other outcomes include symptom improvement, urinary flow, pain score, sexual function, and safety outcomes during follow-up.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Benign prostatic hyperplasia (BPH) is a common condition in aging men and may lead to bladder outlet obstruction and lower urinary tract symptoms. In some patients, clinically significant obstruction and symptoms can occur even when prostate volume is relatively small. Surgical treatment of small-volume BPH remains challenging because these patients may have an increased risk of postoperative bladder neck contracture, and high-quality evidence for the optimal surgical approach is limited.

This study is a multicenter, randomized, single-blind, parallel-controlled clinical trial designed to evaluate the safety and efficacy of thulium laser enucleation of the prostate combined with bladder neck incision in patients with small-volume BPH. A total of 426 male participants aged 40 to 80 years who meet the eligibility criteria will be enrolled and randomly assigned in a 1:1:1 ratio to one of three treatment groups: (1) thulium laser enucleation of the prostate combined with bladder neck incision, (2) thulium laser enucleation of the prostate alone, or (3) transurethral resection of the prostate.

Small-volume BPH in this study is defined as clinically diagnosed BPH with moderate-to-severe lower urinary tract symptoms or impaired voiding function and a prostate volume of less than 30 mL measured by transrectal ultrasound. The primary endpoint is the incidence of bladder neck contracture at 6 months after surgery. Secondary outcomes include safety outcomes and changes from baseline in International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), Visual Analogue Scale (VAS) score, and IPSS response rate at 3 and 6 months after surgery. Exploratory outcomes include changes in post-void residual urine volume and sexual function assessed by the International Index of Erectile Function-5 (IIEF-5) and the Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD).

Participants will undergo screening, surgical treatment, and postoperative follow-up. Follow-up visits will be conducted at 30 ± 3 days, 90 ± 3 days, and 180 ± 7 days after surgery. Outcome assessments will include symptom scores, uroflowmetry, post-void residual urine volume, adverse events, and cystoscopy at the 180-day visit to assess bladder neck contracture. The results of this trial are expected to provide evidence for an optimized surgical strategy for patients with small-volume BPH.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

426

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Kina
    • Beijing Municipality
      • Beijing, Beijing Municipality, Kina, 100039
        • Rekruttering
        • Chinese PLA General Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • 1. Male patients aged 40-80 years; 2. Diagnosis of benign prostatic hyperplasia and scheduled to undergo surgical treatment; 3. International Prostate Symptom Score of at least 12, maximum urinary flow rate of no more than 15 mL/s, with a voided volume greater than 150 mL; 4. Prostate volume of less than 30 mL measured by transrectal ultrasound, calculated as length × width × height × 0.52; 5. Ability, as assessed by the investigator, to understand the study requirements and complete the scheduled treatment, follow-up visits, and study-related assessments.

Exclusion Criteria:

  • 1. Inability or refusal to provide written informed consent, or inability to comply with the required follow-up schedule; 2. Prostate-specific antigen level of 10 ng/mL or higher, unless prostate cancer has been excluded by biopsy; 3. Confirmed or suspected prostate or bladder malignancy; 4. Pre-existing bladder neck contracture or urethral stricture before surgery; 5. Known coagulation disorder or abnormal coagulation function; 6. Neurogenic bladder or detrusor underactivity that may affect bladder or urethral sphincter function; 7. Benign prostatic hyperplasia complicated by acute urinary tract infection, acute prostatitis, or bacterial prostatitis; 8. History of prostate surgery, urethral stricture, or neurogenic bladder; 9. History of prostate cancer or pelvic radiotherapy; 10. Severe cardiovascular disease, pulmonary disease, or other systemic disease that, in the investigator's judgment, would make the patient unable to tolerate surgery; 11. Participation in another clinical trial related to benign prostatic hyperplasia within 3 months before enrolment; 12. Any other condition that, in the investigator's opinion, makes the patient unsuitable for participation in this study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: ThuLEP Combined With Bladder Neck Incision
Participants assigned to this arm will undergo thulium laser enucleation of the prostate combined with bladder neck incision. Hyperplastic prostatic tissue will be enucleated along the surgical capsule plane using a thulium fibre laser system. After enucleation and haemostasis, the bladder neck will be assessed intraoperatively, and bladder neck incision will be performed according to protocol-defined anatomical and obstructive findings when considered safe by the operating surgeon.
Procedure: Thulium Laser Enucleation of the Prostate Combined With Bladder Neck Incision
Participants will undergo transurethral thulium laser enucleation of the prostate combined with bladder neck incision. Hyperplastic prostatic tissue will be enucleated along the surgical capsule plane using a thulium fibre laser system. After enucleation and haemostasis, the bladder neck will be assessed intraoperatively, and bladder neck incision will be performed according to protocol-defined anatomical and obstructive findings when considered safe by the operating surgeon.
Aktiv komparator: ThuLEP Alone
Participants assigned to this arm will undergo thulium laser enucleation of the prostate alone. The procedure will be performed transurethrally, and hyperplastic prostatic tissue will be enucleated along the surgical capsule plane using a thulium fibre laser system, followed by haemostasis of the surgical wound.
Procedure: Thulium Laser Enucleation of the Prostate
Participants will undergo transurethral thulium laser enucleation of the prostate alone. Hyperplastic prostatic tissue will be enucleated along the surgical capsule plane using a thulium fibre laser system, followed by haemostasis of the surgical wound. No bladder neck incision will be performed as part of the assigned intervention.
Andre navne:
  • ThuLEP
Aktiv komparator: Transurethral Resection of the Prostate
Participants assigned to this arm will undergo transurethral resection of the prostate using a conventional resectoscope. Obstructive hyperplastic prostatic tissue will be resected transurethrally according to standard TURP principles to relieve obstruction while avoiding excessive resection and injury to adjacent structures.
Procedure: Transurethral Resection of the Prostate
Participants will undergo transurethral resection of the prostate using a conventional resectoscope. Obstructive hyperplastic prostatic tissue will be resected transurethrally according to standard TURP principles to relieve obstruction while avoiding excessive resection and injury to adjacent structures.
Andre navne:
  • TURP

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of Bladder Neck Contracture
Tidsramme: 6 months after surgery (180 ± 7 days)
Bladder neck contracture will be assessed based on postoperative symptoms, changes in urinary flow, cystoscopic findings, and investigator judgment.
6 months after surgery (180 ± 7 days)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of Postoperative Retrograde Ejaculation
Tidsramme: Up to 6 months after surgery
Incidence of postoperative retrograde ejaculation during follow-up.
Up to 6 months after surgery
Incidence of Device-Related New-Onset Severe Urinary Retention
Tidsramme: Up to 6 months after surgery
Incidence of device-related new-onset severe urinary retention. Severe urinary retention is defined as urinary retention lasting more than 14 days after postoperative healing.
Up to 6 months after surgery
Incidence of Device-Related New-Onset Stress Urinary Incontinence
Tidsramme: Up to 6 months after surgery
Incidence of device-related new-onset stress urinary incontinence during follow-up.
Up to 6 months after surgery
Incidence of Device-Related Bleeding Events Requiring Blood Transfusion
Tidsramme: Up to 6 months after surgery
Incidence of device-related bleeding events requiring blood transfusion during follow-up.
Up to 6 months after surgery
Incidence of Device-Related Urethral or Prostatic Capsule Rupture Requiring Surgical Intervention
Tidsramme: Up to 6 months after surgery
Incidence of device-related urethral or prostatic capsule rupture requiring surgical intervention during follow-up.
Up to 6 months after surgery
Change From Baseline in International Prostate Symptom Score (IPSS)
Tidsramme: 3 months and 6 months after surgery
Change from baseline in International Prostate Symptom Score (IPSS).
3 months and 6 months after surgery
IPSS Response Rate
Tidsramme: 3 months and 6 months after surgery
Proportion of participants achieving improvement in IPSS from baseline of at least 30%, 40%, or 50%.
3 months and 6 months after surgery
Change From Baseline in Maximum Urinary Flow Rate (Qmax)
Tidsramme: 3 months and 6 months after surgery
Change from baseline in maximum urinary flow rate (Qmax).
3 months and 6 months after surgery
Change From Baseline in Visual Analogue Scale (VAS) Score
Tidsramme: 3 months and 6 months after surgery
Change from baseline in Visual Analogue Scale (VAS) score.
3 months and 6 months after surgery

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change From Baseline in Post-Void Residual Urine Volume (PVR)
Tidsramme: 1 month, 3 months, and 6 months after surgery
Change from baseline in post-void residual urine volume (PVR).
1 month, 3 months, and 6 months after surgery
Change From Baseline in International Index of Erectile Function-5 (IIEF-5)
Tidsramme: 1 month, 3 months, and 6 months after surgery
Change from baseline in International Index of Erectile Function-5 (IIEF-5) score.
1 month, 3 months, and 6 months after surgery
Change From Baseline in Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD)
Tidsramme: 1 month, 3 months, and 6 months after surgery
Change from baseline in Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) score.
1 month, 3 months, and 6 months after surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Chinese PLA General Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. maj 2026

Primær færdiggørelse (Anslået)

1. juni 2028

Studieafslutning (Anslået)

1. juni 2028

Datoer for studieregistrering

Først indsendt

29. april 2026

Først indsendt, der opfyldte QC-kriterier

29. april 2026

Først opslået (Faktiske)

6. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. april 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • ThuLEP-BNI-2026-161

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

No plan to share individual participant data at this time.

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