Safety and efficacy of low-powered holmium laser enucleation of the prostate in comparison with plasma kinetic resection of prostate.

Abstract

To compare the efficacy and safety of low-power holmium laser enucleation of the prostate (LP-HoLEP) with plasma kinetic resection of prostate (PKRP). Sixty-three patients treated with transurethral LP-HoLEP (observation group) and 68 patients treated with transurethral PKRP (control group) at Beijing Hospital of Traditional Chinese Medicine from November 2019 to November 2022 were retrospectively compared with regard to operation duration, intra-operative blood loss, prostate resection ratio, postoperative bladder irrigation time, postoperative indwelling urinary catheter time, postoperative urinary incontinence incidence, International Prostate Symptom Scale (IPSS), maximum urine flow rate (Qmax), and residual urine volume (RUV). In both groups, postoperative IPSS, Qmax, and RUV were significantly improved compared to preoperative values (P < 0.05). Comparing the observation group to the control group, the intra-operative blood loss were (59.6 ± 18.1) and (173.1 ± 85.3) ml, respectively (t = -10.350, P < 0.01); the prostate resection ratios were (81.2 ± 4.6) % and (56.7 ± 9.7)%, respectively (t = 18.230, P < 0.01); the postoperative bladder irrigation time was (39.1 ± 9.6) h and (49.7 ± 6.0) h, respectively (t = -7.623, P < 0.01); and the postoperative indwelling urinary catheter time was (111.5 ± 19.4) h and (120.4 ± 12.8) h, respectively (t = -3.125, P < 0.01). Comparing the observation group to the control group, the operation duration was (76.2 ± 18.6) and (83.0 ± 32.4) min, respectively, with no statistical difference (t = -1.226, P = 0.208); the postoperative urinary incontinence incidence was 12.7% and 8.8%, respectively and there was no statistical difference (χ² = 0.514, P = 0.473). LP-HoLEP offers excellent surgical efficacy and safety. LP-HoLEP is superior to PKRP in intra-operative blood loss, postoperative bladder irrigation time, and postoperative indwelling urinary catheter time, and can enucleate more hyperplastic glands.