SURGICAL STRESS RESPONSE IN HOLMIUM LASER ENUCLEATION OF THE PROSTATE VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE: A PROSPECTIVE NON- RANDOMIZED STUDY

Aim: To compare immunoinflammatory markers and the surgical stress response in patients undergoing conventional transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HoLEP). Materials and Methods: Patients with the diagnosis of benign prostate hyperplasia who needed surgical treatment were enrolled in either TURP or HoLEP surgery. Two consecutive cohorts of 25 patients in each group were non-randomly recruited based on prostate volume. Interleukin-6, C-reactive protein, tumor necrosis factor alpha, white blood cell count, neutrophilto-lymphocyte ratio, CD4+/CD8+ ratio, and adrenaline and cortisol levels were determined at three different times: before the operation, immediately afterward, and on postoperative day 1. Operation durations, lengths of in hospital stays, and postoperative pain scores were also assessed. Results: The mean age was 63.1 +/- 6.7 years. Interleukin-6 and C-reactive protein values were statistically higher in both groups at postoperative day 1 than preoperatively (p < 0.05). Interleukin-6 and C-reactive protein levels were significantly higher in the TURP at postoperative day 1 than HoLEP (p < 0.05). The operation duration in the TURP group was significantly shorter than in the HoLEP. The length of hospital stay was shorter in the HoLEP (p < 0.05). There was less postoperative pain in the HoLEP (p < 0.05). Conclusion: This study shows that surgical stress response is attenuated in patients undergoing HoLEP surgery in comparison with patients receiving TURP surgery.