A comparison of minimally invasive management of benign prostate hyperplasia.

This trial was carried out to look at the safety, effectiveness, and cost-effectiveness of holmium enucleation (HE) of the prostate and bipolar transurethral enucleation (BTE) of the prostate in patients with benign prostatic hyperplasia (BPH). The authors found that both techniques were similarly effective, while HE had a shorter hospital stay, operative time, and earlier catheter removal.

BPH is the non-cancerous increase in the size of the prostate gland. BPH can cause symptoms such as frequent urination, trouble starting to urinate, and a weak stream while urinating. Other symptoms include being unable to pass urine or loss of bladder control. This happens because the increased prostate tissue blocks urine flow through the urethra (the tube that passes urine out from the bladder). LUTS/BPH can lead to problems relating to the QoL and mental health issues.

The standard treatment of BPH involves the removal of extra prostate tissue through the urethra. Over the years, minimally invasive techniques have been developed for this. HE uses a laser to remove enlarged prostate tissue that may be blocking the flow of urine. BTE is the use of electrical currents to remove enlarged prostate tissue. Previous studies have not compared HE to BTE in the treatment of BPH. 

107 patients with BPH were evaluated for this trial. Half of the patients received HE and half BPE. The average prostate size was 135.2mL in patients who underwent HE and 125mL for those who had BTE. Patients were followed up for 1 year.

HE was found to be associated with a shorter average surgery time (83.43 minutes) compared to 94.7 minutes for BTE. HE was also associated with a shorter time patients needed a catheter inserted (1 day vs 1.79 days) and a shorter hospital stay (1 day vs 1.49 days) compared with BTE. 

Both groups showed significant improvements in symptoms after receiving treatment compared to before treatment. Symptoms and quality of life were similar in both groups at 1, 3, and 12 months after the procedures.

Cost-wise, HE was less expensive when compared to BTE. 

The authors found that both HE and BTE were safe and effective in treating patients with BPH, while HE was chapter and involved shorter surgery and hospital stay.

This study involved a small number of patients from one medical center. The results may not apply to patients treated elsewhere. Further studies are needed to confirm these results.