A comparative study between holmium laser enucleation of the prostate and transurethral resection of the prostate: 12-month follow-up

Background: This was a prospective randomized clinical trial to compare the safety and efficacy of holmium laser enucleation of the prostate and transurethral resection of the prostate for surgical treatment of patients with bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Patients and methods: From December 2009 to October 2010, 60 consecutive patients with lower urinary tract obstruction (LUTs) due to BPH were randomized to either surgical treatment with HOLEP (group 1, n = 30) or standard TURP (group 2, n = 30). Preoperative assessments included American Urological Association (AUA) symptom score, serum prostate-specific antigen, (SPSA), post-void residual urine volume (PVR), transrectal ultrasound (TRUS) anduroflowmetry. Perioperative parameters included total operating time, resected tissue weight, hemoglobin loss, presence or absence of blood transfusion, time of catheter removal and duration of hospital stay. Postoperative evaluations were conducted at one, three, six and 12 months. Results: Patients in the HOLEP group had shorter catheterization time and hospital stay, but longer operating time. Mean hemoglobin loss was lower in the HOLEP group (0.900 +/- 0.419 g/dl vs 1.157 +/- 0.918 g/dl). The follow-up results up to 12 months regarding AUA symptom score, PVR urine volume and Qmax showed that both groups were comparable. Complications: Complications were similar between the two procedures with no significant difference. Conclusion: HOLEP proved to be a safe and highly effective technique for surgical treatment of bladder outlet obstruction due to BPH.