Transurethral resection versus holmium laser enucleation of the prostate

Abstract

Objectives: The purpose of this study was to compare transurethral resection of the prostate (TURP) versus holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH) focusing on perioperative thrombin generation and fibrinolysis. Methods: Sixty-five BPH patients were prospectively randomly assigned to undergo TURP (n = 32) or HoLEP (n = 33). The prothrombin fragment (PF) 1+2, thrombin-antithrombin complex (TAT), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) were measured preoperatively, at the 1st day and 3rd day after surgery. Results: PF1+2, TAT, t-PA, and PAI-1 significantly elevated at day 1 and day 3 after surgery ( P < .05) and remarkedly decreased from the 1st day to the 3rd day ( P < .05). The levels of PF1+2 and TAT were higher in TURP group postoperatively than that in HoLEP group ( P < .05). There is no significant difference between 2 groups in regard of t-PA and PAI-1 ( P > .05). Conclusion: The activation of thrombin generation and fibrinolysis system were noticed in BPH patients after TURP or HoLEP. TURP may associate with a higher hypercoagulable thrombotic risk than HoLEP.

Effect of remote ischemic preconditioning on fibrin formation and metabolism in patients undergoing hip fracture surgery: a randomized clinical trial

“…In our study, focusing on the activation of coagulation, we demonstrated that F1+2 concentrations rose in response to surgery as previously described [37–39], but RIPC had no effect on F1+2 levels confirming recent findings in RIPC patients undergoing elective head and neck cancer surgery [17].…”

Shifting Trends in Prostate Treatment: A Systematic Review Comparing Transurethral Resection of the Prostate and Holmium Laser Enucleation of the Prostate

“…HoLEP is also associated with a shorter operative time, as reported by Song et al [40], Shah et al [41], Jhanwar et al [42], and Elshal et al [43]. However, there are findings of a longer operative time for HoLEP compared to Transurethral Resection of the Prostate (TURP), as reported by Sinha et al [44] and Bai et al [45], which aligns with the results of a recent systematic review on the same topic [31]. This suggests that TURP may be superior to HoLEP.…”

“…When it comes to HoLEP, it results in a shorter duration of hospital stay, as mentioned in studies by Jefferson et al [ 37 ], Elshal et al [ 43 ], Sinha et al [ 44 ], Bai et al [ 45 ], Prudhomme et al [ 46 ], and El-Hawy et al [ 48 ]. This is supported by a recent systematic review on the same topic [ 31 ].…”

“…It is also associated with decreased drops in hemoglobin levels, reduced blood loss, and fewer side effects during the perioperative period [ 56 ]. In contrast, TURP has been associated with more activation of thrombin generation, a higher thrombotic tendency, and is linked to a hypercoagulable state [ 45 ].…”

Prognostic value of coagulation markers in patients with colorectal cancer: A prospective study

“…TAT, a complex created by the interaction of thrombin and antithrombin, is a reliable indicator of the body's thrombin levels. Elevated TAT indicates coagulation activation, which exists in cancer patients 31 . Yang et al 32 showed that patients with malignant tumors might use elevated plasma TAT levels to diagnose thrombosis because they signify an aberrant increase in coagulation and fibrinolytic activity.…”