A Comparative Study on Outcome of Holmium Laser Enucleation of Prostate and Transurethral Resection of Prostate in Prostatic Hyperplasia

Abstract

Objective: To compare the frequency of hematuria and mean length of stay as outcome of holmium laser enucleation of prostate (HoLEP) and transurethral resection of prostate (TURP) group with benign prostatic hyperplasia. Methodology: Study was randomized trial, conducted in Urology department of General hospital, Lahore, for Six months. Sampling technique was consecutive. Those who were willing, randomly allocated in two groups by using lottery method. In Group A, patients undergone HoLEP and in Group B, TURP. After surgery, irrigation started with normal saline solution. Irrigation time was noted. Patients were shifted in ward and followed for next 24 hours. If blood was present in urine grossly, then hematuria was labeled. Clinically and vitally stable patients were discharged from wards and hospital stay was also noted. Data was collected on preformed Performa and analyzed on SPSS. Results: Total 108 patients fulfilling the inclusion criteria participated. Main outcome variables in this study were frequency of hematuria and length of stay (LOS) in hospital of patients in both treatment groups. Statistical significance was calculated using two-tailed test. As per findings of this study it was seen that patients frequency of hematuria was significantly higher in patients who were treated with TURP (HoLEP: 3.7% vs. TURP: 29.6%, p-value=0.000) while LOS in hospital was also significantly higher for patients who were treated with TURP (HoLEP: 41.65±10.63 vs. TURP: 54.02±10.44, p-value=0.000). Conclusion: Holmium laser enucleation is better than transurethral resection of prostate in terms of shorter hospital stay and low frequency of hematuria postoperatively. HoLEP can replace TURP but more studies required with long term effects.