What question did this study set out to answer?

To evaluate and compare the 36-month safety and clinical efficacy of holmium laser enucleation of the prostate against bipolar transurethral resection of the prostate in large-volume benign prostatic hyperplasia.

November 17, 2021International Journal of Urology

Holmium laser enucleation versus bipolar resection in the management of large‐volume benign prostatic hyperplasia: A randomized controlled trial

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Authors

EHEnmar HabibCairo University MAMohamed F. AbdallahAarhus University MEMohammed S. ElSheemyCairo University

Discussion

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Implication

Randomized trial demonstrates superior safety and efficacy for holmium laser enucleation over bipolar resection in large-volume benign prostatic hyperplasia, indicating laser surgery is preferred.

Key Points

To evaluate and compare the 36-month safety and clinical efficacy of holmium laser enucleation of the prostate against bipolar transurethral resection of the prostate in large-volume benign prostatic hyperplasia.
Randomized controlled trial conducted between December 2016 and March 2018 allocating 112 patients with benign prostatic hyperplasia (prostate volume ≥80 cc) to either holmium laser enucleation (n=57) or bipolar transurethral resection (n=55).
Follow-up occurred through 36 months under an intention-to-treat framework, assessing the primary outcome of hemoglobin loss alongside operative parameters and long-term functional recovery.
Univariate and multivariable logistic regression analyses identified independent predictors of operative duration and perioperative hemoglobin loss across all participants.
Holmium laser enucleation achieved significantly lower hemoglobin loss (P < 0.001), faster operative time (P = 0.019), higher operative efficiency (P < 0.001), shorter catheterization duration (P < 0.001), and reduced hospital stays (P < 0.001) compared with bipolar resection.
Overall complications did not differ significantly between arms (P = 0.128), but blood transfusions occurred exclusively in the bipolar resection group (P = 0.026).
At 3 years, holmium laser enucleation maintained significantly better International Prostate Symptom Scores, prostate-specific antigen reductions, and maximum urinary flow rates compared to bipolar resection (P < 0.05).

Cite This Study

Habib et al. (2021) studied this question.

synapsesocial.com/papers/6a0033612ff633f36577d765 https://doi.org/10.1111/iju.14737

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Implication

Randomized trial demonstrates superior safety and efficacy for holmium laser enucleation over bipolar resection in large-volume benign prostatic hyperplasia, indicating laser surgery is preferred.