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Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center prospective randomized trial in patients with obstructive benign prostatic hyperplasia.

Authors :
Montorsi F
Naspro R
Salonia A
Suardi N
Briganti A
Zanoni M
Valenti S
Vavassori I
Rigatti P
Source :
The Journal of urology [J Urol] 2008 May; Vol. 179 (5 Suppl), pp. S87-90.
Publication Year :
2008

Abstract

Purpose: To our knowledge we report the first multicenter, prospective, randomized study comparing holmium laser enucleation (HoLEP) and transurethral prostate resection (TURP) for obstructive benign prostatic hyperplasia.<br />Materials and Methods: From January to October 2002, 100 consecutive patients with symptomatic obstructive benign prostatic hyperplasia were randomized at 2 centers to surgical treatment with HoLEP (52 in group 1) or TURP (48 in group 2). Patients in the 2 groups were preoperatively assessed by scoring subjective symptoms questionnaires. Preoperative and perioperative parameters were also evaluated, the latter at 1, 6 and 12 months of followup.<br />Results: At baseline all patients had obstruction (Schäfer grade greater than 2). At the 1, 6 and 12-month followups no statistically significant differences were observed between the 2 groups in terms of urodynamic findings and subjective symptom scoring. In the HoLEP group mean total time in the operating room +/- SD was significantly longer than for TURP (74 +/- 19.5 vs 57 +/- 15 minutes, p <0.05), while catheterization time (31 +/- 13 vs 57.78 +/- 17.5 minutes, p <0.001 and hospital stay (59 +/- 19.9 vs 85.8 +/- 18.9 hours, p <0.001) were significantly shorter in the HoLEP group. Transient stress and urge incontinence were more common in the HoLEP group, although at the 12-month followup results were comparable. The overall complication rate was comparable in the 2 groups. Erectile function was also maintained in the followup period from baseline in each group, as expected.<br />Conclusions: HoLEP and TURP were equally effective for relieving obstruction and lower urinary tract symptoms. HoLEP was associated with shorter catheterization time and hospital stay. At 1 year of followup complications were similar in the 2 groups.

Details

Language :
English
ISSN :
1527-3792
Volume :
179
Issue :
5 Suppl
Database :
MEDLINE
Journal :
The Journal of urology
Publication Type :
Academic Journal
Accession number :
18405765
Full Text :
https://doi.org/10.1016/j.juro.2008.03.143