A retrospective study comparing holmium Laser enucleation vs. transurethral resection for the treatment of benign prostatic hyperplasia

Objective Benign prostatic hyperplasia (BPH) is a common condition in aging men that significantly impacts quality of life. This study aimed to compare the perioperative outcomes and short-term efficacy of holmium laser enucleation of the prostate (HoLEP) vs. transurethral resection of the prostate (TURP) in patients with symptomatic BPH. Methods We retrospectively analyzed data from 176 patients who underwent surgical treatment for BPH at our institution between January 2019 and December 2024. Patients were divided into two groups: HoLEP ( n = 92) and TURP ( n = 84). Baseline characteristics, operative parameters, postoperative complications, and functional outcomes in 6-month after surgery were compared between the groups. Results Baseline demographics and prostate volume were similar between the two groups. The HoLEP group showed significantly shorter operation time (58.26 ± 20.11 min vs. 84.17 ± 36.80 min, P < 0.001), shorter catheterization time (5.37 ± 1.45 vs. 6.27 ± 1.47 days, P < 0.001), and reduced hospital stay (7.33 ± 3.12 vs. 13.61 ± 4.14 days, P < 0.001). Both groups demonstrated significant improvement in functional outcomes, but HoLEP had better international prostate symptom score, higher Qmax, (all P < 0.05). HoLEP had lower urinary tract irritation (22.62% vs. 42.86%) and erectile dysfunction (16.67% vs. 29.76%, both P < 0.05). Conclusion HoLEP is a safe and effective alternative to TURP for BPH, offering advantages in perioperative safety and early recovery. It may be particularly beneficial in patients with large prostates or higher bleeding risk.