Key result
HoLEP links to faster prostate blood flow normalization by 24 weeks versus TUEB in BPH.
Why the study?
Many aspects of the clinical use of transrectal Doppler ultrasound to study blood flow changes in the prostate after transurethral surgical interventions for BPH remain unclear.
Does transurethral enucleation of BPH with the laser method (HoLEP) compared to the bipolar method (TUEB) improve prostate blood flow recovery in patients with BPH?
Cohort (n=88)
Does transurethral enucleation of BPH with the laser method (HoLEP) compared to the bipolar method (TUEB) improve prostate blood flow recovery in patients with BPH?
Laser transurethral enucleation of BPH is associated with faster normalization of prostate blood flow parameters compared to bipolar enucleation.
HoLEP was associated with faster prostate blood flow recovery than TUEB; leaves open whether this improves clinical outcomes in BPH.
BACKGROUND: Transrectal Doppler ultrasound is the leading method for studying blood flow in the prostate. Despite a significant number of studies on the use of ultrasound of the prostate in patients with BPH, many aspects of its clinical use remain unclear. One of these issues is the features of changes in blood flow in the prostate after transurethral surgical interventions. AIM: to assess the state of blood flow in the prostate gland in patients with BPH before and after transurethral enucleation by laser and bipolar methods. MATERIALS AND METHODS: The study included 88 patients with BPH aged 50 to 79 years who complained of urinary disorders. All patients underwent transurethral enucleation of BPH: 41 patients with the laser method (HoLEP) (1st group) and 47 patients with the bipolar method (TUEB) (2nd group). Before surgical treatment, 4, 12 and 24 weeks after surgery, patients underwent transrectal Doppler ultrasound of the prostate. RESULTS: The results of the study indicate a significant impact of surgery on the state of blood flow in the prostate gland. Examination 12 weeks after the operation showed a significant decrease in the peak blood flow velocity and values of the resistance index in patients of the 1st and 2nd groups compared with the corresponding values before the surgery and 4 weeks after the surgery. By 24 weeks after surgery, all patients showed normalization of blood flow parameters, while in patients of the 1st group (HoLEP) this process occurred faster than in patients of the 2nd group (TUEB). CONCLUSIONS: The high diagnostic efficiency and informativeness of transrectal Doppler ultrasound in the assessment of blood circulation in the prostate in patients with BPH has been confirmed. The blood flow velocity in the subcapsular and especially paraurethral arteries, as well as the values of the resistance index, were higher in patients with large prostates, which must be taken into account when planning surgical interventions.
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Kalinina et al. (2022) conducted a cohort in Benign prostatic hyperplasia (BPH) (n=88). Laser transurethral enucleation (HoLEP) vs. Bipolar transurethral enucleation (TUEB) was evaluated on State of blood flow in the prostate gland (peak blood flow velocity and resistance index). Laser transurethral enucleation (HoLEP) led to faster normalization of prostate blood flow parameters by 24 weeks post-surgery compared to bipolar enucleation (TUEB) in patients with BPH.
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