Volume 25, Issue 108, February, 2021

Holmium laser enucleation versus bipolar transurethral resection of the prostate in management of benign prostatic hyperplasia

Ahmed Lotfy Ghazy El Gohary^1♦, Mohamed Sherief Mourad², Mohamed Mohamed Yassin³, Ahmed Farouk⁴, Ahmed Ibrahim Radwan⁵

¹Assistant Lecturer of Urology/Specialist, Ain Shams University Hospitals, Cairo, Egypt; Email: dr.ahmedlotfy2012@gmail.com
²Professor of Urology, Ain Shams University Hospitals, Cairo, Egypt; Email: msmourad@tedata.net.eg.
³Assistant Professor of Urology, Ain Shams University Hospitals, Cairo, Egypt; Email: dryassinmm@gmail.com
⁴Assistant Professor of Urology, Ain Shams University Hospitals, Cairo, Egypt; Email: dr_farouk77@yahoo.com
⁵Consultant of Urology/Lecturer, Ain Shams University Hospitals, Cairo, Egypt; Email: Ahmedradwan67@gmail.com

^♦Corresponding author
Assistant Lecturer of Urology/Specialist, Ain Shams University Hospitals, Cairo, Egypt; Email: dr.ahmedlotfy2012@gmail.com

ABSTRACT

Objective: To compare the efficacy and safety of Holmium enucleation of the prostate (HoLEP) versus Bipolar transurethral resection of the prostate (BTURP) in the management of benign prostatic hyperplasia. Methods: In our randomized controlled trial, 60 patients were allocated into 2 equal groups representing HoLEP and BTURP. Perioperative data were collected regarding the prostate size, post voiding residual urine (PVRU), international prostate symptom score (IPSS), peak urine flow rate (Qmax), and Quality of life affection (QoL). Operative parameters were recorded according to operative, enucleation, and resection time in addition to the volume of resected tissues and intraoperative complication. Patients were followed up at 1 and 12 months postoperative by PVRU, IPSS, Qmax, and QoL assessment. Results: Sixty patients finished our follow up period and their data were analyzed. The mean prostate size was 74.23 ± 9.58 ml and 72.6 ± 10.01 ml for HoLEP and BTURP groups respectively. Operative efficacy measures were comparable in both groups. HoLEP was associated with an earlier catheter removal time of 1.07 ± 0.25 days compared to 3.07 ± 0.78 days in the BTURP. Postoperative PSA, IPSS, QoL, PVRU, and Qmax were comparable in both groups and they both showed statistically significant improvement in the aforementioned parameters following treatment. There was no statistically significant difference between both groups regarding the complication rate. Conclusion: Both HoLEP and BTURP are safe and effective in the surgical management of benign prostatic hyperplasia. However, HoLEP has an early catheter removal, and shorter hospital stay.

Keywords: Enucleation, prostate, holmium laser, bipolar, endoscopy, lower urinary tract symptoms, prostatic hyperplasia

Medical Science, 2021, 25(108), 328-336

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