Abstract
ObjectivePhotoselective vaporization of the prostate (PVP) using GreenLight and Holmium laser enucleation of the prostate (HoLEP) is an important surgical technique for management of benign prostate hyperplasia (BPH). We aimed to compare the effectiveness and safety of PVP using a 120 W GreenLight laser with HoLEP in a small prostate volume.MethodsPatients who underwent PVP or HoLEP surgery for BPH at our institutions were reviewed from May 2009 to December 2014 in this retrospective study. Among them, patients with prostate volumes < 40 mL based on preoperative trans-rectal ultrasonography were included in this study. Peri-operative and post-operative parameters—such as International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and complications—were compared between the groups.ResultsPVP was performed in 176 patients and HoLEP in162 patients. Preoperative demographic data were similar in both groups, with the exception of PVR. Operative time and catheter duration did not show significant difference. Significant improvements compared to preoperative values were verified at the postoperative evaluation in both groups in terms of IPSS, QoL, Qmax, and PVR. Comparison of the postoperative parameters between the PVP and HoLEP groups demonstrated no significant difference, with the exception of IPSS voiding subscore at 1 month postoperatively (5.9 vs. 3.8, P< 0.001). There was no significant difference in postoperative complications between the two groups.ConclusionOur data suggest that PVP and HoLEP are efficient and safe surgical treatment options for patients with small prostate volume.
Highlights
Benign prostatic hyperplasia (BPH) is a common condition in aging males and is the most common cause of lower urinary tract symptoms (LUTS) [1]
photoselective vaporization of the prostate (PVP) was performed in 176 patients and holmium:YAG laser enucleation of the prostate (HoLEP) in162 patients
Significant improvements compared to preoperative values were verified at the postoperative evaluation in both groups in terms of International Prostate Symptom Score (IPSS), quality of life (QoL), Qmax, and post-void residual urine (PVR)
Summary
Benign prostatic hyperplasia (BPH) is a common condition in aging males and is the most common cause of lower urinary tract symptoms (LUTS) [1]. The association of prostate volume and LUTS in patients with BPH remains controversial despite numerous studies. Surgical treatment of LUTS secondary to small prostate volume is controversial, it is regarded as an alternative treatment for patients refractory to medical therapy. In a study comparing TURP with HoLEP with matched prostate volumes, HoLEP is an effective treatment modality in a small prostate volume [7]. PVP and HoLEP have been used in patients with small-to-medium-sized BPH causing BOO according to international guidelines. Few studies have directly compared PVP and HoLEP in patients with a small prostate volume [9]. The present study analyzed the efficacy and safety of the PVP using 120W GreenLight laser versus HoLEP in patients with LUTS due to a small prostate volume (< 40 mL)
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