Comparison of HoLEP and TURP in Terms of Efficacy in the Early Postoperative Period and Perioperative Morbidity

Abstract

Objectives: We conducted this study to compare the safety and efficacy of transurethral resection of the prostate (TURP) and holmium laser prostatectomy. Methods: A total of 30 patients eligible for surgery for symptomatic benign prostatic hyperplasia were included in the study. They were randomized into two groups of 15 each. The patients were evaluated at 3 weeks, 3 and 9 months. Results: Preoperative parameters were comparable between the 2 groups. The mean operative time was longer in the holmium laser enucleation of prostate (HoLEP) group (53 ± 9.84 vs. 43 ± 9.36 min; p = 0.001). The intraoperative adverse events were comparable. The mean traction time (26.80 ± 5.9 vs. 19.60 ± 3.6 h; p = 0.0001), irrigation time (30 ± 7.68 vs. 19.40 ± 1.15 h; p = 0.0001), and duration of indwelling catheter (78.20 ± 17.84 vs. 46.42 ± 14.25 h; p = 0.0001) were significantly less in the HoLEP group as compared to the TURP group. Two patients (13.66%) in the TURP group had significant hematuria. Two patients in the HoLEP group vs. none in the TURP group developed urinary incontinence (p < 0.05). Significant improvements were observed in IPSS score, PFRs and PVRs in both the groups and maintained at 9 months. Conclusions: HoLEP is safe and effective in the surgical management of benign prostatic hyperplasia, with the advantage of reduced intraoperative hemorrhage and perioperative morbidity.

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“…Advantages of HoLEP such as; increased removal of tissue amount, shorter bladder irrigation time and fewer perioperative complications are similar to other studies [10][11][12][13][14][15][16]. For catheterization time, we found no significant difference between HoLEP and TURP, although Holmium laser technique is considered significantly shorter [11,[13][14]. As for operating time, HoLEP has a longer surgery time due to prolonged morcellation which is similar to other related studies [10][11][14][15][16].…”

“…In the present study, we report our experience of HoLEP compared to TURP. Advantages of HoLEP such as; increased removal of tissue amount, shorter bladder irrigation time and fewer perioperative complications are similar to other studies [10][11][12][13][14][15][16]. For catheterization time, we found no significant difference between HoLEP and TURP, although Holmium laser technique is considered significantly shorter [11,[13][14].…”

“…For catheterization time, we found no significant difference between HoLEP and TURP, although Holmium laser technique is considered significantly shorter [11,[13][14]. As for operating time, HoLEP has a longer surgery time due to prolonged morcellation which is similar to other related studies [10][11][14][15][16]. Longer operation time in HoLEP might be associated with removal of more prostatic tissue by HoLEP than TURP and prolonged morcelation time.…”

Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia

“…TURP have been performed [20][21][22]. In one of the first multicenter, prospective randomized trials, Montorsi et al [23] enrolled 100 men with symptomatic BOO.…”

An update on holmium laser enucleation of the prostate and why it has stood the test of time

“…Many patients, however, will suffer symptoms of bladder outlet obstruction and yet be found to have a prostate that is not massively enlarged. Mavuduru et al [22] studied such a group of patients as they performed a randomized controlled trial comparing HoLEP with TURP for men with prostates less than 40 g. Although TURP was more rapid to perform, HoLEP was associated with less bleeding and reduced irrigation, shorter duration of catheterization, and hospitalization. When primary outcomes were assessed, there was no difference between the groups in terms of AUA and quality-of-life symptom scores and peak urinary flow rate.…”