{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:43:53Z","timestamp":1782740633327,"version":"3.54.5"},"reference-count":19,"publisher":"PAGEPress Publications","issue":"2","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Objectives: To estimate the learning curve for thulium laser enucleation of the prostate (ThuLEP) performed by the same surgeon, appreciating the sequential progression in skill and proficiency over time.\nPatients and methods: The study retrospectively enrolled 60 patients with benign prostatic hyperplasia (BPH) who underwent the ThuLEP procedure performed by a single experienced endourologist. Though not initially skilled with laser enucleation of the prostate, the surgeon had observed numerous cases before. The patients were divided into three groups, each containing 20 cases. The procedure started with inspection, followed by incision and trough creation and plane development, apicolateral dissection, sphincter release, anterior dissection, bladder neck dissection, C-shaped baso-lateral dissection, and adenoma detachment technique called veil-sparing ThuLEP using the ABCD method. Perioperative parameters, enucleation and morcellation time (min), enucleation efficiency (g\/min), morcellation efficiency (g\/min), enucleated tissue weight (g), hospital stay time, and catheterization time (h) were recorded.\nResults: There was a statistically significant decrease in the International Prostate Symptom Score (IPSS) 6 months postoperatively (median = 3) compared with 1-day postoperatively (median = 4) and preoperatively (median = 25). Uroflowmetry parameters, IIEF-5 scores, enucleation and morcellation efficiency, hospitalization period, and catheterization time were evaluated, showing substantial improvements and stabilization over time.\nConclusions: A highly skilled endourologist in TURP was able to master the learning curve of ThuLEP after completing the initial 40 patients. Upgrading the sequential progression in skill and proficiency over time for treating benign prostatic hyperplasia in addition to its safety, feasibility, efficacy that improve procedure outcome with fewer difficulties.<\/jats:p>","DOI":"10.4081\/aiua.2026.15191","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T09:01:44Z","timestamp":1780650104000},"source":"Crossref","is-referenced-by-count":0,"title":["The learning curve of thulium laser enucleation of the prostate: a single-centre experience"],"prefix":"10.4081","volume":"98","author":[{"given":"Ahmed Y.","family":"Aboelsaad","sequence":"first","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Al-Azhar University, Damietta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Abdel Gawad","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Al-Azhar University, Damietta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman M.","family":"El-Daydamony","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama M.","family":"Ghoneimy","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed I.","family":"Elshater","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of medicine, Al-Azhar University, Cairo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany","family":"Elsegeay","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of medicine, Al-Azhar University, Assiut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Wahsh","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of medicine, Al-Azhar University, Assiut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamal M.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of medicine, Al-Azhar University, Assiut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed M.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of medicine, Al-Azhar University, Assiut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek M.","family":"Abuelazayem","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of medicine, Al-Azhar University, Assiut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama I.","family":"Obeidat","sequence":"additional","affiliation":[{"name":"Department of Urology, Burjeel Royal Hospital, Abu Dhabi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-3425","authenticated-orcid":false,"given":"Tamer A.","family":"Abouelgreed","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"233604","doi-asserted-by":"crossref","unstructured":"1. Razzak M. BPH: HoLEP--a steep learning curve but better for patients. Nat Rev Urol. 2013; 10:66.","DOI":"10.1038\/nrurol.2012.236"},{"key":"233605","doi-asserted-by":"crossref","unstructured":"2. Bozzini G, Berti L, Aydog\u02d8an TB, et al. A prospective multicenter randomized comparison between Holmium Laser Enucleation of the Prostate (HoLEP) and Thulium Laser Enucleation of the Prostate (ThuLEP). World J Urol. 2021; 39:2375-2382.","DOI":"10.1007\/s00345-020-03468-6"},{"key":"233606","doi-asserted-by":"crossref","unstructured":"3. Gilling PJ, Kennett K, Das AK, et al. Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol. 1998; 12:457-459.","DOI":"10.1089\/end.1998.12.457"},{"key":"233607","doi-asserted-by":"crossref","unstructured":"4. Herrmann TR, Bach T, Imkamp F, et al. Thulium laser enucleation of the prostate (ThuLEP): transurethral anatomical prostatectomy with laser support. 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World J Urol. 2013; 31:1231-1238.","DOI":"10.1007\/s00345-012-0894-1"},{"key":"233611","doi-asserted-by":"crossref","unstructured":"8. Saredi G, Pirola GM, Pacchetti A, et al. Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience. BMC Urol. 2015; 15:1-7.","DOI":"10.1186\/s12894-015-0045-2"},{"key":"233612","doi-asserted-by":"crossref","unstructured":"9. Seung-June Oh. Current surgical techniques of enucleation in holmium laser enucleation of the prostate. Invest Clin Urol. 2019;60:333-342.","DOI":"10.4111\/icu.2019.60.5.333"},{"key":"233613","doi-asserted-by":"crossref","unstructured":"10. Aboutaleb H, Ali TA, Zaghloul A, Amin MM. Efficacy of bipolar \u2018button\u2019 plasma vaporisation of the prostate compared to green laser vaporisation for benign prostatic obstruction. Journal of Clinical Urology. 2018; 11:350-356.","DOI":"10.1177\/2051415817752855"},{"key":"233614","unstructured":"11. Wozniak RH. Introduction to memory: Hermann Ebbinghaus (1885\/1913). Classics in the history of psychology. 1999."},{"key":"233615","doi-asserted-by":"crossref","unstructured":"12. Wright TP. Factors affecting the cost of airplanes. Journal of the Aeronautical Sciences. 1936; 3:122-128.","DOI":"10.2514\/8.155"},{"key":"233616","doi-asserted-by":"crossref","unstructured":"13. Luft HS, Bunker JP, Enthoven AC. Should operations be regionalized? The empirical relation between surgical volume and mortality. New Eng J Med. 1979; 301:1364-1369.","DOI":"10.1056\/NEJM197912203012503"},{"key":"233617","unstructured":"14. Gravas S, Cornu JN, Drake M, et al. Management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO). ISBN (Print) 978-94-92671-01-1, ISSN (Print) 2588-817X."},{"key":"233618","doi-asserted-by":"crossref","unstructured":"15. Pirola GM, Saredi G, Codas Duarte R, et al. Holmium laser versus thulium laser enucleation of the prostate: a matched-pair analysis from two centers. Ther Adv Urol. 2018; 10:223-233.","DOI":"10.1177\/1756287218779784"},{"key":"233619","unstructured":"16. Herrmann T, Kallidonis P, Kotsiris D, et al. Surgeons\u2019 self assessed learning curve for Thulium-assisted Laser Prostatectomy: Evaluation of a nationwide Survey. Hellenic Urology 2017; 29:46-53."},{"key":"233620","doi-asserted-by":"crossref","unstructured":"17. Aydogan TB, Binbay M. Learning curve of ThuLEP (Thulium laser enucleation of the prostate): Single-centre experience on initial consecutive 60 patients. Andrologia. 2022; 54:e14366.","DOI":"10.1111\/and.14366"},{"key":"233621","doi-asserted-by":"crossref","unstructured":"18. Bae J, Oh SJ, Paick JS. The learning curve for holmium laser enucleation of the prostate: a single-center experience. Korean J Urol. 2010; 51:688.","DOI":"10.4111\/kju.2010.51.10.688"},{"key":"233622","doi-asserted-by":"crossref","unstructured":"19. Y\u0131ld\u0131r\u0131m \u00dc, Ezer M, Uslu M, \u00d6rs B. En bloc enucleation of the prostate with early apical release using a high-power (200 W) thulium device: studying a learning curve. Rev Assoc Med Bras (1992). 2023; 69:e20230325","DOI":"10.1590\/1806-9282.20230325"}],"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15191\/14127","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/15191\/14127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T12:44:21Z","timestamp":1782737061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/15191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,29]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2026.15191","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,5]]}}}