Comparison of therapeutic effects of green laser enucleation of the prostate and transurethral prostate resection for treatment of benign prostatic hyperplasia

Abstract

Objective To evaluate the therapeutic effect of green laser enucleation of the prostate (GreenLEP) and transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia (BPH). Methods From February, 2017 to November, 2018, 104 patients with BPH were treated with either GreenLEP (52 cases) or TURP (52 cases) in our hospital. The operation time, intraoperative bleeding volume, resected prostate volume, postoperative bladder irrigation time, postoperative catheter indwelling time and hospitalization time as well as the international prostate symptom scores (IPSS), quality of life (QoL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), prostate specific antigen (PSA), and prostate volume (PV) before and at 1 month and 6 months after the operation were compared between the 2 groups. Results The symptoms and quality of life of the patients improved significantly after the operation in both groups. Compared with those in TURP group, the patients in GreenLEP group had better postoperative Qmax (22.03±3.01 vs 19.08±2.62 mL/s, P < 0.001) and IPSS (5.35±1.67 vs 7.92±2.19, P < 0.001) with similar QoL, PVR, PSA, and PV. In patients with a PV no greater than 60 mL, the postoperative bladder irrigation time was significantly shorter in GreenLEP group than in TURP group (18.88±2.36 vs 34.33±2.90 h, P < 0.001). In patients with a PV of 60-80 mL, compared with the TURP group, the GreenLEP group had significantly less intraoperative blood loss (63.30±4.27 vs 77.28±6.19 mL, P < 0.001) and shorter postoperative bladder irrigation time (23.11±1.91 vs 41.56±3.15 h, P < 0.001) and postoperative hospital stay (3.07±0.61 vs 3.88±0.88 days, P < 0.001) without significant differences in the operation time or prostatectomy volume. In patients with a PV beyond 80 mL, the assessed parameters in GreenLEP group were all superior to those in TURP group (P < 0.001). The GreenLEP group recorded a significantly higher incidence of postoperative transient urinary incontinence but lower incidences of postoperative hyponatremia, sexual dysfunction, electrocut syndrome and postoperative blood transfusion than TURP group (P < 0.05). Conclusion For treatment of BPH, GreenLEP has similar therapeutic effect to TURP, but GreenLEP is associated with reduced intraoperative bleeding, shorter postoperative bladder irrigation time and postoperative hospital stay and lowered incidences of postoperative complications especially in patients with a large PV.

Keywords

• benign prostatic hyperplasia
• green laser enucleation of prostate
• transurethral prostate resection