The Comparison Between Holmium Laser Enucleation And Transurethral Resection Of The Prostate On The Treatment Of Symptomatic BPH In The Near Future

Objective: To get an all around, objective assessment on holmium laser enucleation of the prostate (HoLEP) ,which is a new technique on the treatment of benign prostatic hyperplasia (BPH) in our country, through comparing therapy results in the near future of HoLEP with thansurethal resection of the prostate(TURP) directly. Methods: In the randomized comparison, we made out the indexes which would be monitored and recorded during the research prospectively. A total of 140 men with symptomatic BPH and meeting the criterions of the research were treated with either HoLEP or TURP during the period from November 2001 to Octorber 2002 in our center, thus the patients were divided into two groups: Group HoLEP and Group TURP, 70 patients each group. Standard assessments including International Prostate Symptom Score(IPSS), Quality of Life Score(QOLS), prostate specific antigen(PSA), digital rectal examination, pressure-flow urodynamics,ultrasound prostate volume and post-voiding residual urine measurement were performed in each patient preoperatively. Operation time , postoperative bladder irrigating time and catheterizing time were recorded. IPSS, QOLS, uroflometry were repeated respectively at both 3 and 6- months visit. Pressure-flow urodynamics was also repeated at 6 months postoperatively. All complications were noted. The data was performed statistical analysis.Results: 55 patients in Group HoLEP and 58 in Group TURP were visited at both 3 and 6 months.There was no significant difference between the two groups for any preoperative parameter. Both holmium laser and transurethral resections resulted in significant improvements in IPSS, QOLS, peak urinary flow rate(Qmax), detrusor pressure at Qmax(Pdet/Qmax) and post-voiding residual urine volumn(RUV). The degree of improvements was similar between the two groups(P>0.05). Operation time was almost equivalent but postoperative bladder irrigating time, catheterizing time and admission days of HoLEP group were significant less compared to the TURP group. There were fewer side effects such as blood transfusion, transurethral resection syndrome(TURS) in the holmiumgroup. Effects on retrograde ejaculation, urethral stricture and reoperation rate were similar with 6-months followup.Conclusions: (1) HoLEP is as effective as TURP for the treatment of symptomatic BPH in the near future according to our research results. (2) HoLEP yields fewer adverse side effects and less recovering time compared to TURP. (3)HoLEP may be a substitute for TURP.