A comparison of treatment methods for benign prostate hyperplasia and urinary symptoms

This study compared Green-Light (GL) and Holmium Laser (HL) Vapo-enucleation surgery (VES) with transurethral resection of the prostate (TURP) in the treatment of urinary symptoms in patients with benign prostatic hyperplasia (BPH). Researchers suggested that GL-VES and HL-VES were better than TURP in the treatment of these patients.

Benign prostatic hyperplasia (BPH) consists of an increase in the size of the prostate gland. As the prostate is located near the bladder, it puts pressure on it when enlarged, causing urinary symptoms. This has a negative impact on the quality of life of patients.

TURP was the standard treatment for BPH. It consists of removing part of the prostate through the urethra (urinary tube). However, this surgery was associated with a significant rate of complications.

GL-VES and HL-VES are less invasive types of laser surgery. These surgeries treat blockage of urine flow as a result of an enlarged prostate. These surgeries use different laser concentrated lights to generate intense heat which evaporates the prostate tissue. Prior studies confirmed its effectiveness, safety, and durability. However, it is not clear if these 2 methods are of the same effectiveness as TURP in the treatment of urinary symptoms caused by large-sized prostates.

This study included information about 182 patients with BPH. Patients underwent either GL-VES (60), HL-VES (60), or TURP (62). Patients were followed up for 3 years.

Longer surgery time and less surgery effectiveness were reported in patients who received GL-VES compared to HL-VES and TURP. Complications and the need for other procedures were similar between the 3 methods. However, a higher level of prostate capsule disruption (8%) was seen in the TURP group compared to GL-VES (1.6%) and HL-VES (0%). TURP was also associated with longer hospital stay and catheter-time and a higher need for blood transfusions.

At 3 years, re-treatment for bladder blockage was more frequent in patients who received GL-VES (6.7%) and TURP (9.7%) than HL-VES (0%).  

This study concluded that GL-VES and HL-VES have better outcomes than TURP in the treatment of urinary symptoms caused by enlarged prostates.

This study had a small number of participants and all procedures took place in one hospital. The results may not apply to patients treated elsewhere. Further, larger studies are needed.