Holmium Laser Enucleation Prostatectomy Versus Open Transvesical Prostatectomy in Prostate more than 80 Grams in Egyptian Men

Abstract

he goals from this study were assessment of the safety and efficacy of Holmium Laser Enucleation Prostatectomy (HoLEP) versus Open Prostatectomy (OP) for prostate glands more than 80 grams due to Benign Prostatic Hyperplasia (BPH) in Egyptian men regarding quality of life, micturition parameters and complications. One hundred and ten (110) patients were assigned and randomly divided into HoLEP (55 patients) and OP (55 patients). The inclusion criteria were American urological association-symptom score (AUA-SS) of eight or higher, maximum urinary flow rate (Qmax) of 10ml/s or less, postvoiding residual urine (PVUR) of 50 ml or more, and a total prostate volume of 80 cc or more in transrectal ultrasound (TRUS). The exclusion criteria included previous prostate or urethral surgery and non–BPH related voiding disorders. Follow-up for each group was assessed in 1st, 2nd weeks, 1st, 3rd, 6th, and 12th months after surgery. Perioperative parameters for each group were operative time, enucleation specimen weight, post-operative serum hemoglobin, length of hospital stay, and the duration of the indwelling catheter. The assessment was in the form of AUA-SS, Qmax, PVUR volume, and reporting on complications. The pre-operative parameters didn’t reveal statistically significant differences between the two groups. Operative time was statistically significantly shorter in the HoLEP group compared to the OP group (102.45 vs 170.45 min respectively). Drop-in hemoglobin concentration was statistically significantly higher in the OP group compared to the HoLEP group. Moreover, the duration of catheterization and hospital stay were statistically significantly shorter in the HoLEP group compared to the OP group. On the other hand, AUA-SS, PVUR volume, and Qmax didn’t reveal statistically significant differences between the two groups.