Comparison of clinical results between TUR-P and holmium laser enucleation of the prostate (HoLEP) based on the initial experience

Abstract

(Objective) We compared the surgical results between holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TUR-P) for the treatment of men with benign prostatic hyperplasia (BPH). (Methods) A total of 87 patients with symptomatic BPH were analysed. HoLEP was performed on 46 men (mean age 68.2 ± 7.5 years old) from December 2005 to February 2007, and TUR-P was performed on 41 men (mean age 69 ± 7.3 years old) from April 2004 to March 2006. (Results) Both groups were comparable in terms of age, pre-operative IPSS, QOL index, urodynamic study results and prostate volume. During operation, decrease in hemoglobin was less in the HoLEP group than in the TUR-P group (1.15± 1.2 vs 1.91 ± 1.3 g/dl p<0.05). The operation time was significantly longer in the HoLEP group than in the TUR-P group (161.9 ± 65.0 vs 118.3 ± 36.9 minutes p<0.001). Mean resected weight was 29.3 ± 13.3 g (10-55) in the TUR-P group and 34.8 ± 33.4 g (5-148) in the HoLEP group (p = 0.337). The catheterization period (52.1 ± 29.6 vs 115.2 ± 27.5 hour p< 0.001) and hospital stay (6.6 ±2.3 vs 9.4 ±2.2 days p< 0.001) were significantly shorter in the HoLEP group than in the TUR-P group. At follow up, Qmax, average flow rate and post void residual urine (PVR) in two groups improved significantly, and these parameters were not significantly different between the groups after 3 months. (Conclusions) Both TUR-P and HoLEP were effective in relieving BOO. The estimated blood loss, a catheterization time and hospitalization were less or shorter in the HoLEP group. HoLEP may be a good alternative to the conventional transurethral electrocautery resection of the prostate for symptomatic BPH.