[Monoplane versu biplane holmium laser enucleation of the prostate for the treatment of large-volume benign prostatic hyperplasia].

OBJECTIVE

To compare the clinical effect and safety of monoplane holmium laser enucleation of the prostate (MP-HoLEP) from those of biplane HoLEP (BP-HoLEP) in the treatment of large-volume BPH.

METHODS

We retrospectively analyzed the clinical data on 67 cases of large-volume BPH treated in Jintan People's Hospital from June 2017 to December 2018, 30 by MP-HoLEP with incisions at 5- and 7-o'clock positions beside the verumontanum and the other 37 by BP-HoLEP with incision at 12 o'clock in the bladder neck to expose the surgical capsule layer. We compared the perioperative, postoperative and follow-up data between the two groups of patients.

RESULTS

There were no statistically significant differences between the two groups of patients in the age, disease course, prostate volume or preoperative post-void residual urine volume (PVR), maximum urine flow rate (Qmax), IPSS, PSA level and quality of life score (QOL). Compared with the patients in the MP-HoLEP group, those treated by BP-HoLEP showed a significantly shorter operation time (［97.65 ± 34.72］ vs ［125.46 ± 47.58］ min, P < 0.01) and tissue-enucleation time (［60.34 ± 23.45］ vs ［97.43 ± 35.51］ min, P < 0.01) and lower intraoperative level of hemoglobin (［14.58 ± 1.11］ vs ［21.44 ± 1.28］ g, P < 0.01). Statistically significant differences were not observed in the intraoperative adverse events, volume of the resected tissue, time of bladder irrigation or length of postoperative hospital stay, nor in the incidence of transient urinary incontinence (33% vs36.8%, P > 0.05). PVR, Qmax, IPSS and QOL were improved similarly in both of the groups at 6 months postoperatively.

CONCLUSIONS

Both MP-HoLEP and BP-HoLEP are definitely effective for the treated of large-volume BPH, but the latter is superior to the former for shorter operation and enucleation time and less bleeding.