Surgical outcomes of Holmium laser enucleation of the prostate (HoLEP) versus bipolar transurethral enucleation of the prostate (B-TUEP) in benign prostatic hyperplasia patients

Objective: To evaluate the outcomes and safety of the surgical technique Holmium laser enucleation of the prostate (HoLEP) in comparison to bipolar transurethral enucleation of the prostate (B-TUEP) in patients with benign prostatic hyperplasia (BPH) for whom surgery was advised by a single surgeon. Materials and Methods: Data was collected from 36 patients who underwent HoLEP between January 2021 and June 2022 and 36 patients who underwent B-TUEP between January 2023 and August 2024 in Rajavithi Hospital. Demographic characteristics, perioperative results, complications, and functional outcomes of surgery were compared between the two groups. Results: There was no significant difference between the groups in terms of age, blood loss, resected tissue volume, complications and pathology. The operative time, the catheterization time and the length of stay were significantly longer in the HoLEP group. There was significant postoperative improvement in international prostate symptom score (IPSS), quality of life score (QoL), peak flow rate (Q-max), post-void residual urine volume (PVR) and prostate-specific antigen (PSA) in both groups. However, the improvement in the IPSS was significantly better in the B-TUEP group. Conclusions: The outcomes of HoLEP and B-TUEP are comparable regarding safety and efficacy for the treatment of BPH patients. However, HoLEP required a longer operative time, catheterization time and length of stay than B-TUEP.