Comparison of outcomes after holmium laser enucleation of the prostate and transurethral resection of the prostate

Introduction: Benign prostatic hyperplasia (BPH) is the most common benign tumor in men. Holmium laser enucleation of the prostate (HoLEP), is considered a strong competitor to Transurethral resection of the prostate (TURP).
Objective: To determine the differences in short-term and medium-term outcomes of TURP and HoLEP in treatment of bladder outlet obstruction caused by BPH

Material and methods: This was a prospective observational study, carried out on BPH patients who underwent HoLEP or Monopolar TURP from April 2023 to September 2024. A total of 72 patients with prostate volume of less than 100 cc were assigned to two groups. Group A (n = 36) underwent surgical treatment with HoLEP, while Group B (n = 36) underwent monopolar TURP. All the procedures were performed by a single surgeon.

Results: Patients in the HoLEP group experienced shorter catheterization times and hospital stays than those in the TURP group, with both differences being statistically significant (P < 0.001). Additionally, the operating time differed significantly between the two groups, with HoLEP averaging 87.53 ± 15.93 minutes and TURP averaging 67.47 ± 9.98 minutes (P < 0.001). The mean hemoglobin loss was also lower in the HoLEP group (0.76 ± 0.36 g/dL) compared to the TURP group (1.57 ± 0.69 g/dL). At follow-up, both groups showed significant improvements from baseline in AUA symptom scores, Qmax, and PVR urine volumes

Conclusion: HoLEP offers less perioperative morbidity and similar efficacy at three months. Postoperative complications and improvements in symptoms, after HoLEP are comparable to those seen after TURP.