To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH).
This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS).
No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated.
HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up.
Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.
BMC urology. 2021 Feb 23*** epublish ***
Giorgio Bozzini, Matteo Maltagliati, Umberto Besana, Lorenzo Berti, Albert Calori, Maria Chiara Sighinolfi, Salvatore Micali, Jean Baptiste Roche, Ali Gozen, Alexander Mueller, Dimitry Pushkar, Evangelos Liatsikos, Marco Boldini, Carlo Buizza, Bernardo Rocco
Department of Urology, ASST Valle Olona, Via Arnaldo da Brescia, 21052, Busto Arsizio, VA, Italy. ., Department of Urology, ASST Valle Olona, Via Arnaldo da Brescia, 21052, Busto Arsizio, VA, Italy., Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy., ESUT, European Section for UroTechnology, Arnhem, Italy., Department of Urology, Clinique Saint Augustin, Bordeaux, France., Department of Urology, SLK Kliniken, Heilbron, Germany., Department of Urology, Spital Limmattal, Schlieren, Switzerland., Department of Urology, Moscow State University, Moscow, Russia., Department of Urology, University of Patras, Patras, Greece., Department of Urology, Clinica Sant'Anna, Lugano, Switzerland.