Comparison of Clinical Therapeutic Efficacy between TUPKP and HoLEP for Patients Aged 70 Years and Older with Benign Prostatic Hyperplasia: Retrospective Study.

Objective: The occurrence of prostate hyperplasia has increased remarkedly, especially in elderly patients; However, research on which surgical treatment is effective and safe for benign prostatic hyperplasia (BPH) in elderly people over 70 years old is limited. This study aimed to investigate the clinical efficacy and safety of transurethral plasma kinetic prostatectomy (TUPKP) and holmium laser enucleation of prostate (HoLEP) as a therapy for benign prostatic hyperplasia (BPH) in the elderly.

Methods: A total of 148 patients with BPH admitted from December 2022 to December 2023 were chosen and divided into HoLEP (n = 74) and TUPKP (n = 74) groups according to the surgical operation. Perioperative related indexes, preoperative and postoperative international prostate symptom scores and life quality scores were compared between the two groups. The postoperative complications were also counted for the two groups.

Results: The HoLEP group had lower intraoperative bleeding, mean operative time, catheter indwelling time and hospital stays than the TUPKP group (p < 0.001). Before treatment, no significant difference in prostate symptom scores was found between the two groups (p > 0.05). After treatment, the prostate symptom scores in the HoLEP group were significantly lower than those in the TUPKP group (p < 0.001). However, the maximum urinary flow rate was significantly higher (p < 0.001) and the residual urine volume was significantly lower (p < 0.001) in the HoLEP group than in the TUPKP group after operation. The complication rate in the TUPKP group was 25.66%, which was significantly higher than the 9.46% in the HoLEP group (p < 0.05). The life quality scores of the HoLEP group were higher than those of the TUPKP group (p < 0.001).

Conclusions: HoLEP for BPH therapy is effective and safe with low incidence of postoperative complications.