A prospective randomized study compares the safety and efficacy of Holmium laser enucleation of prostate versus bipolar transuretheral resection of prostate for management of benign prostatic enlargement

Background. Holmium laser enucleation of the prostate (HoLEP) is considered the standard endoscopic treatment of benign prostatic hyperplasia (BPH), but traditional HoLEP surgery will cause some postoperative complications. This study was attempted to evaluate the safety and efficacy of modified two-lobe technique versus traditional three-lobe technique of HoLEP focusing mainly on incidences of retrograde ejaculation (RE) and urinary incontinence (UI). Methods. From March 2014 to February 2017, 191 men with BPH were randomly assigned to two groups: 97 underwent modified two-lobe technique; 94 underwent traditional three-lobe technique. All patients were followed up for 12 months. Primary outcomes were incidences of RE and UI, and secondary outcomes were international prostate symptom score (IPSS), quality of life (QOL), maximal urine flowing rate (MFR), and residual urine among the studied patients. Results. Compared with the traditional technique, patients in the modified group had a statistically significant decrease in frequency of UI (1.03% vs 8.51%, p=0.036) and RE in the 6th month (33.33% vs 63.64%, p=0.030) and 12th month (13.33% vs 50%, p=0.034) and a significant increase in ejaculatory volume in the 6th month (p=0.050) and 12th month (p=0.003). Besides, the modified HoLEP was more beneficial to patients according to the change of QoL score at 1 month (p=0.002), 3 months (p=0.004), 6 months (p=0.026), and 12 months (p=0.015). Conclusions. The modified two-lobe technology of HoLEP reduced the incidence of RE and UI, which improved the quality of life of the patients after surgery compared to the traditional three-lobe technology. This trial is registered with ChiCTR1800018553.

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Holmium Laser Enucleation Versus Bipolar Resection of the Prostate: A Prospective Randomized Study. Which to Choose?

Journal of Endourology ◽

10.1089/end.2011.0059 ◽

2011 ◽

Vol 25 (8) ◽

pp. 1347-1352 ◽

Cited By ~ 41

Author(s):

Amr S. Fayad ◽

Mohamed G. El Sheikh ◽

Tamer Zakaria ◽

Hazem A. Elfottoh ◽

Rageb Alsergany

Keyword(s):

Randomized Study ◽

Holmium Laser ◽

Prospective Randomized Study ◽

Laser Enucleation ◽

Holmium Laser Enucleation

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Two-year follow-up after holmium laser enucleation of the prostate and bipolar transurethral resection of the prostate: a prospective randomized study

African Journal of Urology ◽

10.1186/s12301-021-00128-y ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Mamdouh M. El-Hawy ◽

Amr Eldakhakhny ◽

Ahmed AbdEllatif ◽

Emad A. Salem ◽

Ahmed Ragab ◽

...

Keyword(s):

Transurethral Resection ◽

Treatment Options ◽

Randomized Study ◽

Preoperative Assessment ◽

Holmium Laser ◽

Prospective Randomized Study ◽

Significant Difference ◽

Laser Enucleation ◽

Holmium Laser Enucleation

Abstract Background Different treatment options are available for the management of BPH. Our study aimed to compare the surgical outcomes of a holmium laser enucleation of the prostate (HoLEP) and a bipolar transurethral resection of the prostate (Bipolar-TURP) after 2 years. Methods Our prospective randomized study included 114 patients: 55 patients underwent HoLEP procedure and 59 patients underwent bipolar TURP procedure. All patients underwent a complete preoperative assessment and a physical examination. The postoperative follow-up data included Q max and IPSS recordings at 1, 3, 6, 12, and 24 months and PVR urinary volume recordings at 6 and 12 months. Any postoperative complications were also recorded. Results There were no statistically significant differences between both groups regarding IPSS and Q max scores at one and 24 months postoperative. Also, there were no statistically significant differences between both groups regarding postoperative PVR at 6 and 12 months. One patient in the HoLEP group developed total incontinence after surgery. Conclusion Our study did not show a significant difference between HoLEP and bipolar TURP regarding postoperative Q max and IPSS scores at 24 months of follow-up.

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Nerve-Sparing Radical Retropubic Prostatectomy in Patients Previously Submitted to Holmium Laser Enucleation of the Prostate for Bladder Outlet Obstruction Due to Benign Prostatic Enlargement

European Urology ◽

10.1016/j.eururo.2007.07.027 ◽

2008 ◽

Vol 53 (6) ◽

pp. 1180-1185 ◽

Cited By ~ 28

Author(s):

Nazareno Suardi ◽

Vincenzo Scattoni ◽

Alberto Briganti ◽

Andrea Salonia ◽

Richard Naspro ◽

...

Keyword(s):

Bladder Outlet Obstruction ◽

Outlet Obstruction ◽

Radical Retropubic Prostatectomy ◽

Holmium Laser ◽

Nerve Sparing ◽

Benign Prostatic Enlargement ◽

Retropubic Prostatectomy ◽

Prostatic Enlargement ◽

Laser Enucleation ◽

Holmium Laser Enucleation

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Holmium Laser Enucleation of the Prostate Versus Bipolar Resection of the Prostate: A Prospective Randomized Study. “Pros and Cons”

Urology ◽

10.1016/j.urology.2015.08.004 ◽

2015 ◽

Vol 86 (5) ◽

pp. 1037-1041 ◽

Cited By ~ 22

Author(s):

Amr S. Fayad ◽

Mohamed G. Elsheikh ◽

Tamer Zakaria ◽

Hazem A. Elfottoh ◽

Rageb Alsergany ◽

...

Keyword(s):

Randomized Study ◽

Holmium Laser ◽

Prospective Randomized Study ◽

Pros And Cons ◽

Laser Enucleation ◽

Holmium Laser Enucleation

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Outcomes of transurethral resection and holmium laser enucleation in more than 60 g of prostate: A prospective randomized study

Urology Annals ◽

10.4103/0974-7796.198904 ◽

2017 ◽

Vol 9 (1) ◽

pp. 45 ◽

Cited By ~ 15

Author(s):

Ankur Bansal ◽

Ankur Jhanwar ◽

RahulJ Sinha ◽

Gaurav Prakash ◽

Kawaljit Singh ◽

...

Keyword(s):

Transurethral Resection ◽

Randomized Study ◽

Holmium Laser ◽

Prospective Randomized Study ◽

Laser Enucleation ◽

Holmium Laser Enucleation

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Factors Associated With Early Recovery of Stress Urinary Incontinence Following Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Enlargement

International Neurourology Journal ◽

10.5213/inj.1836092.046 ◽

2018 ◽

Vol 22 (3) ◽

pp. 200-205 ◽

Cited By ~ 8

Author(s):

Kang Jun Cho ◽

Jun Sung Koh ◽

Jin Bong Choi ◽

Joon Chul Kim

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Holmium Laser ◽

Benign Prostatic Enlargement ◽

Early Recovery ◽

Factors Associated ◽

Prostatic Enlargement ◽

Laser Enucleation ◽

Holmium Laser Enucleation

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Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

BMC Urology ◽

10.1186/s12894-021-00797-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Giorgio Bozzini ◽

Matteo Maltagliati ◽

Umberto Besana ◽

Lorenzo Berti ◽

Albert Calori ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Operative Time ◽

Randomized Study ◽

Urine Volume ◽

Holmium Laser ◽

Laser Enucleation ◽

Holmium Laser Enucleation ◽

Irrigation Volume

Abstract Background To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

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