Document Detail

Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients.
MedLine Citation:
PMID:  15311026     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Transurethral electrocautery resection (TURP) is generally regarded as the gold standard surgical treatment for bladder outflow obstruction due to benign prostatic hyperplasia despite its rather high morbidity. The high powered holmium:YAG laser can be used endoscopically to enucleate obstructing prostatic tissue in a relatively bloodless manner. The technique of transurethral holmium laser enucleation of the prostate (HoLEP) was compared to standard TURP for the surgical management of prostate adenomas in a randomized, prospective clinical trial. MATERIALS AND METHODS: A total of 200 urodynamically obstructed patients with a prostate of less than 100 gm on transrectal ultrasound were randomized to HoLEP or TURP. All patients were assessed preoperatively, and 1, 6 and 12 months postoperatively. Patient baseline characteristics, perioperative data and postoperative outcome were compared. All complications were noted. RESULTS: HoLEP was significantly superior to TURP in terms of catheter time, hospital stay and hemoglobin loss but operative time was longer. HoLEP and TURP resulted in a significant improvement in American Urological Association symptom scores, peak urinary flow rates and post-void residual urine volumes with symptoms scores and residual volume significantly better in the holmium group. Effects on continence and potency were similar in the 2 groups but adverse events were less frequent in the holmium group. CONCLUSIONS: HoLEP and TURP are highly effective procedures for removing obstructing prostatic adenomas. HoLEP resulted in significantly better micturition parameters and less perioperative morbidity.
Rainer M Kuntz; Sascha Ahyai; Karin Lehrich; Amr Fayad
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of urology     Volume:  172     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-16     Completed Date:  2004-09-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1012-6     Citation Subset:  AIM; IM    
Urology Department, Auguste Viktoria Hospital, Berlin, Germany.
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MeSH Terms
Aged, 80 and over
Electrocoagulation / adverse effects
Laser Therapy* / adverse effects
Middle Aged
Postoperative Complications
Prostatic Hyperplasia / physiopathology,  surgery*
Transurethral Resection of Prostate* / methods

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