Int J Urol: In patients with large-volume benign prostatic hyperplasia, which is better for holmium laser enucleation or bipolar resection?

For a long time, M-TURP has been the surgery of choice for the treatment of moderate to severe LUTS and small to medium volume prostate BPH
.

However, M-TURP is associated with more serious morbidity when dealing with large-volume prostate hyperplasia

Recently, researchers from Egypt published an article in "Int J Urol", comparing the mid-term safety and efficacy of prostatic holmium laser resection and bipolar transurethral resection of the prostate in the treatment of large-volume benign prostatic hyperplasia
.

Compared with the holmium laser resection of the prostate and the bipolar transurethral prostatectomy, the mid-term safety and efficacy in the treatment of large-volume benign prostatic hyperplasia are compared.
The mid-term safety and efficacy of volume benign prostatic hyperplasia

From December 2016 to March 2018, patients with benign prostatic hyperplasia (≥80cc) were randomized to undergo holmium laser enucleation of the prostate (57 patients) or bipolar transurethral prostatectomy (55 patients)
.

Excluded those patients with international prostate symptom score <13 points, maximum urine flow rate>15ml/sec, or prostate cancer, bladder stones, urethral stricture, neurogenic bladder, or previous prostate surgery

It was found that there was no significant difference in the baseline characteristics of the two groups of patients
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Compared with bipolar transurethral resection of the prostate, the operation time (P=0.

Prostate size and bipolar transurethral resection of the prostate significantly increased hemoglobin loss, the size of the prostate, and a bipolar cystic perforation transurethral resection of the prostate and significantly longer operation time related to size of the prostate and transurethral resection of the prostate bipolar and A significant increase in hemoglobin loss is associated with a significant increase in prostate size, cystic perforation, and bipolar transurethral resection of the prostate are associated with a significant increase in operation time

Follow-up data of HoLEP group and B-TURP group at 36 months after surgery

Follow-up data of HoLEP group and B-TURP group at 36 months after surgery

In summary, holmium laser resection of the prostate and bipolar transurethral resection of the prostate are effective and safe for the treatment of moderate to severe lower urinary tract symptoms caused by large-volume benign prostatic hyperplasia (≥80cc)
.

However, when both of these techniques are available, holmium laser resection of the prostate is preferred because of its better efficacy and safety

Holmium laser resection of the prostate and bipolar transurethral resection of the prostate are effective and safe for the treatment of moderate to severe lower urinary tract symptoms caused by large-volume benign prostatic hyperplasia (≥80cc)

Original source:

Original source:

Enmar Habib, Mohamed Fathi Abdallah, Mohammed Said ElSheemy et al.

 

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