Pyrgidis Nikolaos, Schulz Gerald Bastian, Weinhold Philipp, Atzler Michael, Stadelmeier Leo Federico, Papadopoulos Iason, Stief Christian, Marcon Julian, Keller Patrick
Department of Urology, University Hospital LMU, Munich, Germany.
Prostate Cancer Prostatic Dis. 2025 May 19. doi: 10.1038/s41391-025-00980-x.
Limited data exist on the role of holmium laser enucleation of the prostate (HoLEP), thulium laser enucleation of the prostate (ThuLEP), and transurethral resection of the prostate (TURP) in patients with prostate cancer (PCa). We aimed to analyze their perioperative outcomes and trends.
The German Nationwide Inpatient Data (GRAND) registry was used to identify male patients diagnosed with PCa who underwent HoLEP, ThuLEP, or TURP between 2005 and 2022. Multivariable regression analyses were performed to compare perioperative morbidity and mortality.
A total of 221,768 procedures in patients with PCa were performed: 8160 HoLEP, 2285 ThuLEP, and 211,323 TURP. Although TURP remains the predominant technique, the use of HoLEP and ThuLEP has increased significantly in recent years, representing 17% of all cases by 2022. Perioperative outcomes were worse for TURP, with higher transfusion (8.8%) and ICU admission rates (1.7%) compared to HoLEP and ThuLEP (both 2.5% and ≤1.2%, respectively). Postoperative urinary retention and incontinence rates were also lower for laser enucleation techniques than TURP. In patients with PCa undergoing TURP, perioperative outcomes were worse compared to those without PCa, while outcomes for HoLEP and ThuLEP were comparable regardless of PCa status.
HoLEP and ThuLEP offer improved perioperative outcomes compared to TURP in patients with PCa.
关于钬激光前列腺剜除术（HoLEP）、铥激光前列腺剜除术（ThuLEP）和经尿道前列腺切除术（TURP）在前列腺癌（PCa）患者中的作用，现有数据有限。我们旨在分析它们的围手术期结果和趋势。
使用德国全国住院患者数据（GRAND）登记处来识别2005年至2022年间被诊断为PCa并接受HoLEP、ThuLEP或TURP的男性患者。进行多变量回归分析以比较围手术期发病率和死亡率。
共对PCa患者进行了221,768例手术：8160例HoLEP、2285例ThuLEP和211,323例TURP。尽管TURP仍然是主要技术，但近年来HoLEP和ThuLEP的使用显著增加，到2022年占所有病例的17%。TURP的围手术期结果较差，输血率（8.8%）和重症监护病房（ICU）入住率（1.7%）高于HoLEP和ThuLEP（两者分别为2.5%和≤1.2%）。激光剜除术的术后尿潴留和尿失禁发生率也低于TURP。在接受TURP的PCa患者中，围手术期结果比未患PCa的患者更差，而无论PCa状态如何，HoLEP和ThuLEP的结果相当。
与TURP相比，HoLEP和ThuLEP在PCa患者中提供了更好的围手术期结果。
