B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study.

The aim of this study was to compare the peri-operative and functional results between trans-urethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS) in middle-old patients.

This prospective single-center study included patients over 75 years old treated with B-TURP or HoLEP for BPH associated with LUTS with prostate volume (PV) <100 mL. Primary endpoints were the intra-operative blood loss, percentage of loss of hemoglobin, blood transfusion, complications, and the comparison of functional outcomes. All patients were evaluated at 1, 3, 6, and 12 months of follow-up.

Overall, 96 patients undergoing HoLEP and 104 B-TURP were eligible and enrolled for the study. Post-operative results showed statistically significant differences between the two groups, all in favor of HoLEP group, specifically in terms of removed prostate tissue, PV reduction rate, hemoglobin values at 24 h, hemoglobin loss, operative time, length of hospitalization, days of catheterization, and urinary flow rates. There was no significant difference in terms of postvoid residual urine volume, perioperative complication, blood transfusion, International Prostate Symptom Score (IPSS), and IPSS quality of life scores. Conclusions: In middle-old patients, the HoLEP technique represents a prostate size-independent treatment option with a more favorable safety profile defined by less bleeding, lower blood transfusions, and a significantly lower hemoglobin drop than B-TURP.

Biomedicines. 2022 Dec 10*** epublish ***

Andrea Fuschi, Anastasios D Asimakopoulos, Silvio Scalzo, Alessia Martoccia, Yazan Al Salhi, Paolo Pietro Suraci, Flavia Carbone, Martina Maggi, Giorgio Bozzini, Alessandro Zucchi, Cosimo De Nunzio, Antonio Carbone, Antonio Luigi Pastore

Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 04100 Latina, Italy., Urology Unit, Fondazione PTV Policlinico Tor Vergata, 00185 Rome, Italy., Department of Urology, Sapienza University of Rome, 00161 Rome, Italy., ASST Lariana, 22100 Como, Italy., Department of Urology and Andrology, School of Medicine, University of Pisa, 56126 Pisa, Italy., Department of Urology, Sant'Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy.