Green light top-firing sharp enucleation of prostate versus photoselective vaporisation of prostate for benign prostatic hyperplasia: a randomized controlled trial

Abstract

Objective To compare the efficacy and safety of a novel procedure, green light top-firing, sharp enucleation of the prostate (GTSEP) and the traditional procedure, photoselective vaporisation of the prostate (PVP) in the treatment of benign prostatic hyperplasia (BPH). Methods A total of 154 patients diagnosed with BPH admitted in our hospital from June 2018 to April 2019 were recruited in this study, and then randomly divided into GTSEP group (n=77) and PVP group (n=77). All patients were assessed preoperatively and followed at 1 and 6 month postoperatively. International prostate symptom score (IPSS), quality of life score (QoLs), post-void residual urine (PVR), maximum urine flow rate (Qmax), prostate volume (PV), prostate-specific antigen (PSA) and complications were recorded and compared between the 2 groups. Results There were 74 patients in each group completing the follow-up. No significant differences were found in baseline data between the 2 groups. At 1 and 6 months after surgery, both groups had their lower urinary tract symptoms significantly improved, but there were no significant differences in IPSS, QoLs, PVR, Qmax and PSA between the 2 groups. However, the GTSEP group had significantly shorter operation time (41.0±16.4 vs 50.1±18.1 min, P=0.001), and smaller prostate volume at 6 months after surgery (22.4±2.4 vs 23.3±1.9 mL, P=0.011) when compared with the PVP group. No notable differences were seen in the incidence of intraoperative and postoperative complications between the 2 groups. Conclusion Both GTSEP and PVP achieve good efficacy and safety in BPH treatment. GTSEP can remove larger hyperplastic tissue than PVP, and is superior to PVP in operation efficacy.

Keywords

• benign prostatic hyperplasia
• laser
• enucleation
• vaporization