Holmium Laser enucleation of the prostate (HoLEP) versus Transurethral Resection of the Prostate (TURP)

Abstract

Methods: Methods: patients with symptomatic prostatic hyperplasia and candidates for surgical treatment were selected. Both procedures were explained and they had choosen HoLEP or TURP. At the hospital were collected: age, date of birth, international prostate symptom score, urinary peak flow rate, prostate volume, post-voiding residual urine, globular volume and serum PSA. At the procedure operating time, morcellating time (HoLEP), bladder mucosal injury and intercurrences were collected. At the first postoperative day, globular volume and sodium. Besides that were observed the catheter indwelling time and hospital stay and after 90 days, urinary peak flow rate and international prostate symptom score. Statistical analisys have been done partially by Sinpe® and also by a professional team. Results:Results: Results: Results: Results: twenty patients in HoLEP group and 21 at TURP were operated. Baseline urinary peak flow rate was 8 ml/s in both groups and preoperative international prostate symptom score was 22 in HoLEP and 20 in TURP, very similar. Operative time was 85 minutes in HoLEP and 60 in TURP, p<0.05. Hospital stay was 47 hours for HoLEP and 48 hours to TURP, p<0.05. At 90 day the urinary peak flow rate was raised to 21.5 ml/s in HoLEP group and to 20 ml/s in TURP and the median of international prostate symptom score had been reduced to score 3 in both groups. Conclusion: Conclusion: Conclusion: Conclusion: Conclusion: HoLEP is a feasible technique and is as effective as TURP on symptomatic prostatic hyperplasia surgical treatment.

Initial experience with holmium laser enucleation of the prostate in a urology specialist hospital in Nigeria

“…This was the case in this study. Though the pre-operative Q max in our experience was higher than that found in other studies [7,20,25,40], the change in Q max was still statistically significant with better post-operative results. One of these patients opted for surgery to reduce the number of medications he had to take for multiple medical conditions, even though he was doing well on medical treatment for BPH, and this may have contributed to this finding.…”

“…The average pre-operative prostate size in our experience was higher than those seen elsewhere [7,18,24,25]. While there has been no consensus statement about the impact of race on prostate sizes [26,27], prostates of Asians have been found to be generally smaller than their western counterparts [28].…”

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“…This finding agrees with Barboza LE. et al who reported there was no blood transfusions in HoLEP nor TURP [17]. However, in some reports, HoLEP is superior to TURP in terms of blood transfusion because of excellent hemostatic characteristics of holmium laser and partly due to high blood loss of TURP [7,13].…”

Prostat Cerrahisinde Enükleasyon Teknikleri

“…Liam ve ark., TUR-P grubu (ort.prostat hacmi 70±5gr) ile HoLEP grubunu ( ort.prostat hacmi 77,8±5,6 gr) karşılaştırıldığı bir çalışmada bakılan ürodinamik incelemede postoperatif 6. ayda HoLEP' in TUR-P' ye üstünlük sağlarken 2. yıl sonunda sonuçların eşitlendiği görülmektedir (29). Yapılan çeşitli çalışmalarda da benzer sonuçlar gözlenmektedir (30,31). Bunun aksine diğer bir randomize klinik çalışmada postoperatif 2. yılda AUA semptom skorlamasında HoLEP' in verilerinin daha üstün olduğu (1.7' ye karşı 3.9, p<0.0001), 3. yılda bu skorlamanın her 2 grupta eşitlendiği (2.7' ye karşı 3.3, p=0.17); PMR miktarlarında ise 2.yılda (5.6 ml' ye karşı 19.9 ml, p<0.001) ve 3. yılda (8.4 ml' ye karşı 20.2 ml, p=0.012) HoLEP' in daha üstün olduğu anlaşılmıştır.…”