Comparison of Photoselective Vaporization versus Holmium Laser Enucleation for Treatment of Benign Prostate Hyperplasia in a Small Prostate Volume

Abstract

ObjectivePhotoselective vaporization of the prostate (PVP) using GreenLight and Holmium laser enucleation of the prostate (HoLEP) is an important surgical technique for management of benign prostate hyperplasia (BPH). We aimed to compare the effectiveness and safety of PVP using a 120 W GreenLight laser with HoLEP in a small prostate volume.MethodsPatients who underwent PVP or HoLEP surgery for BPH at our institutions were reviewed from May 2009 to December 2014 in this retrospective study. Among them, patients with prostate volumes < 40 mL based on preoperative trans-rectal ultrasonography were included in this study. Peri-operative and post-operative parameters—such as International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and complications—were compared between the groups.ResultsPVP was performed in 176 patients and HoLEP in162 patients. Preoperative demographic data were similar in both groups, with the exception of PVR. Operative time and catheter duration did not show significant difference. Significant improvements compared to preoperative values were verified at the postoperative evaluation in both groups in terms of IPSS, QoL, Qmax, and PVR. Comparison of the postoperative parameters between the PVP and HoLEP groups demonstrated no significant difference, with the exception of IPSS voiding subscore at 1 month postoperatively (5.9 vs. 3.8, P< 0.001). There was no significant difference in postoperative complications between the two groups.ConclusionOur data suggest that PVP and HoLEP are efficient and safe surgical treatment options for patients with small prostate volume.

Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia

“…There is sufficient evidence for its efficacy comparable with TURP or open surgery. Men taking anti‐coagulants can be safely operated …”

BPH treatment: laser for everyone | Opinion: YES

“…HoLEP success has been reproduced in a number of studies ( 11 ). Recently, some authors described similar results comparing HoLEP and 120W GL ( 12 , 13 ).…”

<p>Comparison of the Safety and Efficacy of Photoselective Vaporization of the Prostate (PVP) and Transurethral Enucleation with a Bipolar System (TUEB): A Single-Center Retrospective Study</p>

“…However, Kim et al reported that there were no differences in the improvements of objective parameters in the comparison between PVP and HoLEP with a small prostate volume of less than 40 mL. 13 Enucleation of a large prostate results in forming a large cavity, which may therefore contribute to the improvement of objective parameters.…”