We aimed to compare early perioperative and functional outcomes of holmium laser enucleation of the prostate (HoLEP) performed with the 30-amp MOSES system and MOSES 2.0 technology.
We retrospectively compared 65 patients who underwent HoLEP with the 30-amp MOSES system and 210 with MOSES 2. 0 between June 2023 and April 2025.Intraoperative and perioperative outcomes were collected and analyzed at 1, 3, and 6 months postoperatively.
The two groups had comparable preoperative characteristics, with median prostate volumes of 105 and 111 cc in the MOSES 2.0 and 30-amp MOSES groups, respectively (p = 0.22). Intraoperatively, the MOSES 2.0 group demonstrated an 8-minute shorter median enucleation time (p = 0.007), a 3-minute shorter median hemostasis time (p < 0.001), and lower energy use (75.7 vs. 92.1 kJ, p < 0.001). Additionally, MOSES 2.0 demonstrated superior enucleation efficiency compared to 30-amp MOSES (2.2 vs. 2 g/min, p = 0.047). Other operative parameters were comparable between the two groups. Both technologies achieved comparable successful same-day trial of void rates of 94% in the MOSES 2.0 group and 93.4% in the 30-amp MOSES group (p = 0.88). Postoperative functional outcomes, including IPSS, QoL, Qmax, PVR, and PSA, were comparable between groups up to 6 months of follow-up.
HoLEP with 30-amp MOSES technology is a safe and effective option for treating benign prostatic obstruction. Both MOSES systems support same-day discharge with comparable safety and functional outcomes. The 30-amp MOSES system may offer a practical alternative for institutions without a dedicated 50-amp power supply. Large randomized controlled trials with longer follow-up are warranted.
World journal of urology. 2026 Jun 22*** epublish ***
Hazem Elmansy, Ahmed Mousa, Amr Hodhod, Ruba Abdul Hadi, Hani Nour, Mohannad Alharbi, Mohamad Baker Berjaoui, Sara-Lynn Tayebi, Monica Morgan, Ricardo R Gonzalez, Ahmed S Zakaria
Houston Methodist Hospital, Houston, TX, USA. ., Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Thunder Bay, ON, Canada., King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia., Theodor Bilharz Research Institute, Giza, Egypt., Qassim University, Buraydah, Qassim, Saudi Arabia., University of Toronto, Toronto, ON, Canada., Western University, London, ON, Canada., Houston Methodist Hospital, Houston, TX, USA.