Benign Prostatic Hyperplasia; Holmium Laser Enucleation versus Bipolar Transurethral Enucleation in treatment of patients with symptomatic BPH

Abstract

Objective: to compare the safety and effectiveness of Holmium Laser Enucleation of Prostate (HoLEP) and Bipolar Transurethral Enucleation of Prostate (B-TUEP) for management of symptomatic > 80 gm prostate over a 6-months follow-up period.

Methods: Through a randomized controlled study 80 patients were divided into two equal groups representing HoLEP and B-TUEP. Operative parameters and perioperative complications were recorded. Six months post-intervention, Patients were assessed by international prostate symptom score (IPSS) and peak urine flow rate (Qmax) with measurement of the post-voiding residual urine (PVR) and compared with the preoperative parameters.

Results: There was no significant difference between both groups in age, prostate size, PSA, Qmax, IPSS and PVR pre-intervention. Operative time and irrigation fluid volume were significantly longer in B-TUEP as well as catheterization duration and hospital stay. While resected tissue weight and complications were not significantly different between both groups. There was significant postoperative improvement in 6 months in IPSS, PVR and Qmax in both groups as compared to preoperative parameters.

Conclusions: Both B-TUEP and HoLEP effectively treat BPH, with HoLEP requiring less hospitalization, catheter indwelling and operative time.