Holmium Laser Enucleation Versus Bipolar Plasmakinetic Resection for Management of Lower Urinary Tract Symptoms in Patients with Large-Volume Benign Prostatic Hyperplasia: Randomized-Controlled Trial
Abstract
Objectives: To compare the safety and efficacy of holmium laser enucleation of prostate (HoLEP) vs bipolar plasmakinetic resection of prostate (BPRP) in the management of large-sized (≥75 g) benign prostatic hyperplasia (BPH). Methods: This randomized-controlled trial recruited 145 symptomatic BPH patients who had failed medical management, and who had undergone either HoLEP (Versa pulse® 100 W; n = 73) or BPRP (AUTOCON® II 400 ESU; n = 72). Both groups were compared using the Mann–Whitney, chi-square, Student-t, or Fisher exact tests as appropriate. Preoperative vs postoperative findings (24 months) were compared using paired t-test or Wilcoxon signed-rank test. Results: The two groups were comparable for most preoperative findings including prostate size (p = 0.629), although HoLEP included more patients on anticoagulants (p = 0.001). HoLEP was associated with significantly less operative duration (p < 0.001), hemoglobin loss (p < 0.001), catheterization duration (p = 0.009), and hospital stay (p < 0.001). There was no significant difference in total complications (p = 0.291) and each separate complication. Blood transfusion was reported only with BPRP (p = 0.058). At 24 months of follow-up, there was significant improvement in all the parameters in each group (International Prostate Symptom Score [IPSS], maximum urinary flow rate [Qmax], quality of life [QoL], and postvoid residual urine [PVRU]; p < 0.001). There was no significant difference between both groups in…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 145 participants or records.
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