A Comparative Study On The Early Results Of Holmium Laser And Transurethral Electrovaporization Resection Of Prostate For Bph

Objective: To evaluate the short-term efficacy of holmium laser enucleation of theprostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH), andcompare the efficacy of holmium laser with transurethral electrovaporization resectionof the prostate (TUEVP).Method: A total of 173 patients who were diagnosed with BPH from December2003 to February 2005 in QiLu Hospital were divided into two groups randomly, ofthem 52 cases underwent HoLEP and 121 cases for TUEVP. The significant markersand therapeutic results were recorded and analyzed, which includes such as Qmax,Pdet/Qmax, IPSS, QOL and at the first month postoperatively. The short-termtherapeutic effects were compared between the two groups.Result:1, There was no significant difference of preoperative factors and the weights ofprostates between the two groups (P>0.05).2, No one needed blood transfusion or developed TURS in both groups.3, The differences were significant between the two groups (P<0.01). The mean timeof operation for TUEVP was (56.2 ±21.9) min , shorter than that for HoLEP, (78.5±27.3) min. The mean volume of irrigating fluid during operation for TUEVP was(18.6±6.8) L , less than that for HoLEP, (28.3 ±7.9) L. Significant difference wasfound between the two groups (P<0.01). However, the blood loss in operation forHoLEP was (129.9±46.9) ml, less than that for TUEVP, (169.9±86.9) ml.4 The blood loss after operation was (31.8 ±15.7) ml in HoLEP group, and (44.4±24.5) ml in TUEVP group. The time of bladder irrigating after operation was (2.8± 0.9) d in HoLEP group, (3.3 ± 0.6) d in TUEVP group. The time of catheterizationwas (5.1 ±0.6) d in HoLEP group, shorter than the (5.5 ± 0.7) d in TUEVP group.Hospital stay was (11.91±2.41) d in HoLEP group, and was (14.68 ± 5.35) d inTUEVP group. Significant difference was found between the two groups in the abovefour markers (P<0.05).5 All the cases were followed up for 1 to 6 months. IPSS, QOL and Qmax wereimproved significantly compared with that of preoperative (P<0.01), but there wasno significant difference between two groups.6 There were 5 cases of urethral stricture and 3 cases of Incontinence of urine and 2cases of impotence in the TUEVP group. While 2 cases of urethral stricture and 1cases of Incontinence of urine and 0 cases of impotence were found in the HoLEPgroup. No significant difference was found between the two groups (P>0.05).Conclusion:1 HoLEP is as effective as TUEVP for the treatment of symptomatic BPH .2 And it yields less adverse effects, more safety and needs shorter postoperativerecovery time than TUEVP. 3 Although it is more difficult for doctors to learn this technology, but it should beperformed extensively when we do more.