Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology
Introduction & Objective :
While it has been reported that holmium laser enucleation of the prostate (HoLEP) is an admirable challenger of transurethral resection of prostate (TURP), there is no comparative study about HoLEP and TURP of which were preferred surgical modality for treatment of acute or recurrent urinary retention (UR) due to benign prostate hyperplasia (BPH). Therefore, we compared surgical outcomes after HoLEP and TURP, and identified predictive factors for favorable outcomes after these surgical treatments for management of UR.
Of total 220 patients who were treated with either HoLEP or TURP, 48 (HoLEP) and 35 (TURP) patients who had the history of acute or recurrent UR were enrolled in this study. Preoperative and perioperative outcomes were retrospectively evaluated, and univariable and multivariable logistic regression analyses were performed to identify predictive factors for favorable outcome 3 months after surgical treatment for management of UR.
TURP had significantly short operative time than HoLEP (70.0 min versus 112.5 min, median, p=0.002). However, other pre-, peri- and post-operative outcomes did not show any significant differences. At 3 months postoperative after HoLEP or TURP, the median decrease in International Prostate Symptom Score (IPSS) was 17.0 (range: 10.0 – 23.0). Patients whose IPSS decreased over 17 points were categorized as an favorable response group after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes (odds ratio = 1.394, P
Conclusions : Both HoLEP and TURP are effective at improving urinary parameter in men with UR. When clinicians plan to perform surgical treatment in UR due to BPH, they should consider that the preoperative severity of symptoms is the most important factor for favorable outcome.
Ki Hong Kim– assistant professor, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Ch'ungch'ong-namdo, Republic of Korea
Si Hyun Kim– Cheonan, Ch'ungch'ong-namdo, Republic of Korea
Hee Jo Yang– Cheonan, Ch'ungch'ong-namdo, Republic of Korea
Doo Sang Kim– Cheonan, Ch'ungch'ong-namdo, Republic of Korea
Chang Ho Lee– Cheonan, Ch'ungch'ong-namdo, Republic of Korea
Youn Soo Jeon– Cheonan, Ch'ungch'ong-namdo, Republic of Korea
Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine
Cheonan, Ch'ungch'ong-namdo, Republic of Korea
My name is Ki Hong Ki,m. I have worked in Soonchunhyang University since 2015. My interests are urologic oncology and endourology.