Comparison of HoLEP and TURP in terms of efficacy in the early postoperative period and perioperative morbidity.

OBJECTIVES

We conducted this study to compare the safety and efficacy of transurethral resection of the prostate (TURP) and holmium laser prostatectomy.

METHODS

A total of 30 patients eligible for surgery for symptomatic benign prostatic hyperplasia were included in the study. They were randomized into two groups of 15 each. The patients were evaluated at 3 weeks, 3 and 9 months.

RESULTS

Preoperative parameters were comparable between the 2 groups. The mean operative time was longer in the holmium laser enucleation of prostate (HoLEP) group (53 +/- 9.84 vs. 43 +/- 9.36 min; p = 0.001). The intraoperative adverse events were comparable. The mean traction time (26.80 +/- 5.9 vs. 19.60 +/- 3.6 h; p = 0.0001), irrigation time (30 +/- 7.68 vs. 19.40 +/- 1.15 h; p = 0.0001), and duration of indwelling catheter (78.20 +/- 17.84 vs. 46.42 +/- 14.25 h; p = 0.0001) were significantly less in the HoLEP group as compared to the TURP group. Two patients (13.66%) in the TURP group had significant hematuria. Two patients in the HoLEP group vs. none in the TURP group developed urinary incontinence (p < 0.05). Significant improvements were observed in IPSS score, PFRs and PVRs in both the groups and maintained at 9 months.

CONCLUSIONS

HoLEP is safe and effective in the surgical management of benign prostatic hyperplasia, with the advantage of reduced intraoperative hemorrhage and perioperative morbidity.