Transurethral resection of the prostate versus transurethral holmium laser enucleation of the prostate for benign prostatic hyperplasia with bladder detrusor overactivity.

Jun-wen Shen; Chuan-jun DU; Fu-ding Bai; Rong-jiang Wang

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Transurethral resection of the prostate versus transurethral holmium laser enucleation of the prostate for benign prostatic hyperplasia with bladder detrusor overactivity.

Author: Jun-Wen SHEN ¹ ; Chuan-Jun DU ² ; Fu-Ding BAI ² ; Rong-Jiang WANG ¹
Author Information

1. Department of Urology, Huzhou First People's Hospital, Huzhou, Zhejiang 313000, China.
2. Department of Urology, The Second Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.
Publication Type:Journal Article
Keywords: benign prostatic hyperplasia; bladder detrusor overactivity; transurethral holmium laser enucleation of the prostate; transurethral resection of the prostate
MeSH: Humans; Lasers, Solid-State; therapeutic use; Length of Stay; Male; Prostate; surgery; Prostatic Hyperplasia; surgery; Quality of Life; Transurethral Resection of Prostate; methods; Treatment Outcome; Urinary Bladder Neck Obstruction; surgery; Urinary Bladder, Overactive; surgery; Urinary Catheterization; statistics & numerical data; Urination; physiology
From: National Journal of Andrology 2016;22(8):720-724
CountryChina
Language:Chinese
Abstract:
ObjectiveTo compare and analyze the effects of transurethral resection of the prostate (TURP) and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with bladder detrusor overactivity.
METHODShis study included 51 cases of BPH with bladder detrusor overactivity treated by TURP and another 58 treated by HoLEP. We evaluated the urination of the two groups of patients during the recovery period and at 3 and 6 months postoperatively.
RESULTSThere were no statistically significant differences in such baseline data as the blood PSA level, prostate volume, International Prostate Symptom Score (IPSS), and quality of life (QOL) between the two groups of patients, except in effective bladder capacity, which was higher in the TURP than in the HoLEP group (［315±59］ vs ［287±76］ ml, P<0.05). Urine storage symptoms were obviously improved in both of the groups postoperatively, with the storage symptoms score significantly decreased from 12.6±4.9 preoperatively to 7.5±3.9 at 3 months and 6.1±4.2 at 6 months after surgery in the TURP group (P<0.01) and from 13.7±5.7 to 7.9±4.2 and 7.0±5.1 in the HoLEP group (P<0.01). HoLEP manifested significant advantages over TURP in the postoperative urethral catheterization time (［2.7±0.8］ vs ［5.1±1.2］ d, P<0.05), postoperative bladder contracture time (［4.1±1.9］ vs ［5.8±2.4］ d, P<0.05), postoperative hospital stay (［4.4±1.8］ vs ［5.9±2.5］ d, P<0.05), and improvement of the maximum urinary flow rate, which was increased from (7.9±3.7) ml/s preoperatively to (16.8±4.3) ml/s at 3 months after surgery in the HoLEP group and from (8.6±3.2) ml/s to (14.6±4.3) ml/s in the TURP group (P<0.05).
CONCLUSIONSBoth TURP and HoLEP can improve bladder function and detrusor overactivity in BPH patients, with similar effects in improving urination at 3 to 6 months after surgery. However, HoLEP has more advantages over TURP during the period of postoperative recovery.