Surgical outcomes of Holmium laser enucleation of the prostate (HoLEP) versus bipolar transurethral enucleation of the prostate (B-TUEP) in benign prostatic hyperplasia patients
DOI:
https://doi.org/10.52786/isu.a.90Keywords:
HoLEP, bipolar transurethral enucleation of the prostate, benign prostatic hyperplasiaAbstract
Objective: To evaluate the outcomes and safety of the surgical technique Holmium laser enucleation of the prostate (HoLEP) in comparison to bipolar transurethral enucleation of the prostate (B-TUEP) in patients with benign prostatic hyperplasia (BPH) for whom surgery was advised by a single surgeon.
Materials and Methods: Data was collected from 36 patients who underwent HoLEP between January 2021 and June 2022 and 36 patients who underwent B-TUEP between January 2023 and August 2024 in Rajavithi Hospital. Demographic characteristics, perioperative results, complications, and functional outcomes of surgery were compared between the two groups.
Results: There was no significant difference between the groups in terms of age, blood loss, resected tissue volume, complications and pathology. The operative time, the catheterization time and the length of stay were significantly longer in the HoLEP group. There was significant postoperative improvement in international prostate symptom score (IPSS), quality of life score (QoL), peak flow rate (Q-max), post-void residual urine volume (PVR) and prostate-specific antigen (PSA) in both groups. However, the improvement in the IPSS was significantly better in the B-TUEP group.
Conclusions: The outcomes of HoLEP and B-TUEP are comparable regarding safety and efficacy for the treatment of BPH patients. However, HoLEP required a longer operative time, catheterization time and length of stay than B-TUEP.
References
Patel ND, Parsons JK. Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian J Urol 2014;30:170-6.
Sinha MK, Pietropaolo A, Hameed BMZ, Gauhar V, Somani B. Outcomes of bipolar TURP compared to monopolar TURP: A comprehensive literature review. Turk J Urol 2022;48:1-10.
Arcaniolo D, Manfredi C, Veccia A, Herrmann TRW, Lima E, Mirone V, et al. Bipolar endoscopic enucleation versus bipolar transurethral resection of the prostate: an ESUT systematic review and cumulative analysis. World J Urol 2020;38:1177-86.
Gilling PJ, Cass CB, Cresswell MD, Fraundorfer MR. Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology 1996;47:48-51.
Cornu JN, Gacci M, Hashim H, Herrmann TRW, Malde S, Netsch C, et al. EAU Guidelines on Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS) [Internet]. 2024 [cited 2024 Jan 1]. Available from: https://d56bochluxqnz.cloudfront. net/documents/full-guideline/EAU-Guidelines-on-Non-Neurogenic-Male-LUTS-2024.pdf
Gauhar V, Gilling P, Pirola GM, Chan VW, Lim EJ, Maggi M, et al. Does MOSES technology enhance the efficiency and outcomes of standard holmium laser enucleation of the prostate? Results of a systematic review and meta-analysis of comparative studies. Eur Urol Focus 2022;8:1362-9.
Sun J, Shi A, Tong Z, Xue W. Safety and feasibility study of holmium laser enucleation of the prostate (HOLEP) on patients receiving dual antiplatelet therapy (DAPT). World J Urol 2018;36: 271-6.
Roehrborn, CG, Teplitsky S, Das AK. Aquablation of the prostate: a review and update. Can J Urol 2019; 26:20-4.
Lee MS, Assmus M, Agarwal D, Large T, Krambeck A. Contemporary practice patterns of transurethral therapies for benign prostate hypertrophy: results of a worldwide survey.” World J Urol 2021;39:4207-13.
Robert G, Cornu J, Fourmarier M, Saussine C, Descazeaud A, Azzouzi A, et al. Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (Ho LEP). BJU Int 2016;117:495-9.
Lourenco T, Armstrong N, N’Dow J, Nabi G, Deverill M, Pickard R, et al. Systematic review and economic modelling of effectiveness and cost utility of surgical treatments for men with benign prostatic enlargement. Health Technol Assess 2008;12:1-146.
Geavlete B, Stanescu F, Iacoboaie C, Geavlete P. Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases-a medium term, prospective, randomized comparison. BJU Int 2013:111:793-803.
Thaidumrong T, Duangkae S, Jiramanee V, Kalapong J, Pisansalhidikam P, Tuipae K. Transurethral Anatomical Enucleation of Prostate (TUAEP) in Benign Prostatic Hyperplasia with Bipolar system: First study in Thailand. J Med Assoc Thai 2019;102:20.
Elsaqa M, Elgebaly O, Sakr M, Youssif TA, Rashad H, Tayeb MME. Comparison of outcomes of holmium laser versus bipolar enucleation of prostates weighing > 80 g with bladder outlet obstruction. Proc (Bayl Univ Med Cent) 2022;36:15-9.
Higazy A, Tawfeek AM, Abdalla HM, Shorbagy AA, Mousa W, Radwan A, et al. Holmium laser enucleation of the prostate versus bipolar transurethral enucleation of the prostate in management of benign prostatic hyperplasia: A randomized controlled trial. Inter J Urol 2021;28:333-8.
Li J, Cao D, Huang Y, Meng C, Peng L, Xia Z, et al. Holmium laser enucleation versus bipolar transurethral enucleation for treating benign prostatic hyperplasia, which one is better? Aging Male 2021;24:160-70.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Insight Urology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
