Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a randomized clinical trial

Sun, Nao; Fu, Yue; Tian, Tengzheng; Gao, Jialin; Wang, Yuantao; Wang, Song; An, Wei

doi:10.1007/s11255-014-0646-9

Cited by 46 publications

(47 citation statements)

References 30 publications

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“…But this parameter was not included in the final analysis because there is no technical counterpart in TURP. The drop in hemoglobin levels in this study was lower than in most published RCTs, and no blood transfusion was necessary at all. In terms of hemostatic control our results favor TURP, but with a median reduction in hemoglobin levels of 1.0 g/dL in the HoLEP cohort, the clinical relevance of this observation has to be questioned.…”

Section: Discussioncontrasting

confidence: 64%

“…Matched for a prostate size of 50 cc, our objective was to evaluate the outcomes of HoLEP for an indication where TURP has been considered the reference method for decades. RCTs comparing HoLEP with TURP in the past years included prostate sizes ranging from about 40 cc up to 80 cc . HoLEP was always at least as effective as TURP in terms of relief of LUTS and urodynamic parameters, but with a more favorable safety profile.…”

Section: Discussionmentioning

confidence: 99%

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A matched‐pair analysis of patients with medium‐sized prostates (50 cc) treated for male LUTS with HoLEP or TURP

Magistro

Westhofen

Stief

et al. 2019

LUTS

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Objectives: To evaluate perioperative parameters, early functional outcomes, and the safety profile in a matched-pair analysis of lower urinary tract symptom (LUTS) patients treated with holmium laser enucleation of the prostate (HoLEP) or transurethral resection of the prostate (TURP). Methods:We conducted a retrospective, matched-pair analysis of 2011 men treated for LUTS in our institution from 2013 to 2017. In the final analysis, 197 patients (HoLEP n = 97; TURP n = 98) were matched for prostate size (50 cc), age, and body mass index, and both cohorts were compared for demographic parameters, clinical outcomes, and adverse events according to the Clavien-Dindo classification.Results: The perioperative assessment revealed a significantly higher tissue retrieval percentage of 75.4% (interquartile range [IQR] 64-81.2) after HoLEP in comparison to 47.3% (IQR 40-54.7) after TURP (P <.001). A shorter surgery time was reported for TURP with a median time of 55.5 minutes (IQR 48-70.5), whereas the median time for HoLEP was 62 minutes (IQR 51-85) (P =.006). The median improvements in International Prostate Symptom Score (IPSS) were 11 points (IQR 5.5-17) and 7 points (IQR 3-14) for HoLEP and TURP, respectively (P =.007). Peak urinary flow rate (Q max ) increased more after HoLEP (12.0 mL/s; IQR 7-23) than after TURP (8.5 mL/s; IQR 5-18.25) (P =.028). With an overall incidence of adverse events of 6% (n = 6) compared to 16% (n = 16%), significantly fewer complications occurred after HoLEP than after treatment with TURP (P <.05). Conclusions:HoLEP is not only an attractive alternative for the enucleation of larger prostates, but it must be considered a size-independent technique with the potential to outdo the current reference method TURP. K E Y W O R D S benign prostatic hyperplasia, holmium laser enucleation of the prostate (HoLEP), lower urinary tract symptoms, transurethral resection of the prostate (TURP)

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

A matched‐pair analysis of patients with medium‐sized prostates (50 cc) treated for male LUTS with HoLEP or TURP

Magistro

Westhofen

Stief

et al. 2019

LUTS

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“…Various studies have compared the efficacies of TURP, OSP, and HoLEP for different PVs [14][15][16]. Many studies have also evaluated the peri-and postoperative advantages of HoLEP [13,14,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Gilling et al [13] compared TURP and HoLEP for 70-mL PV and demonstrated that the HoLEP group had shorter hospitalization time and catheter removal time and higher Qmax postoperatively than the TURP group. Sun et al [14] compared HoLEP and TURP outcomes in 164 BPH patients with < 100-mL PVs. Qmax, PVR, IPSS, and QoL score were similar between the 2 groups 1 month postoperatively, but the HoLEP group demonstrated better outcomes 12 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Gazel

Kaya²,

Yalçın³

et al. 2019

Urol Int

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Introduction: Holmium laser enucleation of the prostate (HoLEP) is becoming the new standard procedure for treating benign prostatic hyperplasia (BPH), a common condition in aging men. Most studies have focused on proving its efficacy in treating large prostates. In this study, we compared its efficacy in treating small (< 80 mL) and large (> 80 mL) prostates. Methods: This prospective study included 119 patients with BPH who underwent HoLEP by the same surgeon between June 2015 and December 2017. They were divided into 2 groups according to their prostate volumes (≤80 mL: Group 1; > 80 mL: Group 2). Various pre- and postoperative parameters were compared within and between the groups. Results: International Prostate Symptom Score (IPSS), postvoid residual (PVR) volume, and voiding time (VT) significantly decreased, and the peak urinary flow rate (Qmax), average urinary flow rate (Qave), and quality of life (QoL) score significantly increased postoperatively in both groups. The postoperative changes in IPSS, QoL score, Qmax, Qave, VT, PVR volume, and hemoglobin levels were not significantly different between the groups. In addition, no significant difference was observed in postoperative complications between the groups. Conclusions: Our results indicate that HoLEP is an effective procedure for treating both small and large prostates.

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“…Recently, an ingenious minimally invasive endoscopic technology known as transurethral enucleation and resection of prostate (TUERP) has emerged for BPH treatment [5]. Compared to the conventional TURP technique, the TUERP bears clear advantages of better security, less blood loss and surgery time, and more complete glands-cutting [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Transurethral Enucleation Resection of the Prostate for Benign Prostatic Hyperplasia on Immune and Stress Response

Yuan¹,

Peng²,

Zeng³

et al. 2016

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This thesis aims to examine the effects of the systemic immune response triggered by the transurethral enucleation and resection of the prostate (TRERP). 60 patients with benign prostatic hyperplasia (BPH) were randomly classified into enucleation group and resection group. The level of WBC, serum IL-6, IL-8, CRP, IgG, IgA, IgM, CD4+, CD8+,and ratio of CD4+ to CD8+ (BPH)were compared and analyzed preoperatively and on the 1st, 3rd, 5th of postoperative day. The result demonstrates the statistical significance of the differences between the two groups on the amount of resected tissues, postoperative blood loss, and operation time. To the contrary, there was no statistical significance of the differences on WBC, IL-6, IL-8 and CRP level. To elaborate, on the 1st postoperative day, the values of WBC, IL-6, IL-8 and CRP level were significantly higher, whereas the values of IgG, IgA, IgM, CD4+, CD8+ level and ratio of CD4+ to CD8+ of both groups were significantly lower. On the 3rd postoperative day, there was statistical significance of the differences between two groups on WBC, IL-6, IL-8, CRP level. On the 5th post operative day, however, no statistical significance of differences existed on the IgG, IgA, IgM, CD4+, CD8+ level and ratio of CD4+ to CD8+. It is concluded that compared to the transurethral resection of the prostate (TURP) for Benign prostatic hyperplasia (BPH), TRERP has prominent advantages of more radical resection, less blood loss and less immune suppression.

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Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a randomized clinical trial

Abstract: Compared to TURP, HoLEP was safer and had better long-term efficacy as assessed by multiple quantitative measures. Therefore, HoLEP may present a better option in the treatment of BPH.

Cited by 46 publications

References 30 publications

A matched‐pair analysis of patients with medium‐sized prostates (50 cc) treated for male LUTS with HoLEP or TURP

A matched‐pair analysis of patients with medium‐sized prostates (50 cc) treated for male LUTS with HoLEP or TURP

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

The Effect of Transurethral Enucleation Resection of the Prostate for Benign Prostatic Hyperplasia on Immune and Stress Response

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Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a randomized clinical trial

Abstract: Compared to TURP, HoLEP was safer and had better long-term efficacy as assessed by multiple quantitative measures. Therefore, HoLEP may present a better option in the treatment of BPH.

Cited by 46 publications

References 30 publications

A matched‐pair analysis of patients with medium‐sized prostates (50 cc) treated for male LUTS with HoLEP or TURP

A matched‐pair analysis of patients with medium‐sized prostates (50 cc) treated for male LUTS with HoLEP or TURP

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and &#x3e; 80 mL

The Effect of Transurethral Enucleation Resection of the Prostate for Benign Prostatic Hyperplasia on Immune and Stress Response

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Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL