Comparative Analysis of Greenlight Laser Photovaporization and Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia Surgery.

OBJECTIVE

This study aims to compare efficacy and safety between photoselective vaporization of the prostate (PVP) with Green- Light laser and Holmium laser enucleation of the prostate (HoLEP).

MATERIALS AND

METHODS

A total of 220 patients who underwent endoscopic disobstruction surgery of the prostate were included; Of which, 110 had PVP and 110 had HoLEP (prospective cohort). Preoperative, intraoperative and postoperative variables were recorded, including hospital stay, catheterisation duration, adverse effects, transfusion rate, maximum urinary flow (Qmax) at 12 months, reduction of prostate-specific antigen (PSA) at 6 months, urgency, urinary continence and urethral stricture. Statistical analysis was performed with Fisher's exact, Student's t and Mann-Whitney U tests, with a significance level of p < 0.05.

RESULTS

Both groups presented comparable preoperative characteristics. No significant differences were observed in the days of admission, days of catheterisation, adverse effects, transfusion rate or readmission rate. However, the HoLEP group showed a significantly higher Qmax (31.31 mL/s vs. 24.48 mL/s, p = 0.014) and a greater reduction in PSA (94.54% vs. 47.11%, p = 0.008). Urgency was lower in the HoLEP group (0.9% vs. 11.8%, p = 0.001), and the rate of urinary continence was identical in both groups (99.09%). Urethral stricture was higher in the HoLEP group (4.5% vs. 0.9%, p = 0.219), although the difference was not statistically significant (p > 0.05).

CONCLUSIONS

Overall, PVP and HoLEP present a low morbidity rate and present similar long-term urinary continence rates. Moreover, HoLEP offers a greater improvement in urinary flow and a greater reduction in PSA but leads to a higher rate of urethral stricture than PVP.