In a nutshell
The study compared outcomes of holmium laser enucleation (HLE) and plasmakinetic enucleation (PKE) in men with prostates larger than 60 mL in volume. The main finding was that both HLE and PKE are safe and effective for these patients.
Some background
Benign prostatic hypertrophy (BPH) is an enlargement of the prostate gland. It often results in a blockage in urine flow and leads to urinary symptoms. HLE and PKE are two types of endoscopic surgeries used for treating BPH. Endoscopic surgery involves specialized instruments to view and operate. It uses smaller cuts than open surgery. Enucleation surgery means the removal of the bulky prostate tissue that is blocking the urine flow.
HLE uses a laser to remove prostate tissue. PKE uses an electrode to burn the extra prostate tissue. Studies comparing HLE to PKE in patients with prostates larger than 60 ml in a real-life setting are lacking.
Methods & findings
The study included a total of 200 patients with BPH. 100 patients received HLE and the rest 100 were given PKE based on the surgeons’ practice. Urinary symptoms and quality of life (QoL) scores were evaluated at 3 months and 1 year after the surgeries.
After 3 months, average urinary symptoms and QoL scores were similar between both groups. The decrease in urinary symptoms after 1 year was 79.3% for HLE and 80.3% for PKE.
The average surgery times were 122.4 minutes for PKE and 142.1 minutes for HLE. The average time a catheter (tube to pass urine) was 44.4 hours for PKE and 59.6 hours for HLE. The average hospitalization time was 1.8 days for PKE and 2.5 days for HLE.
Urinary tract infections and surgical complications occurred at similar rates in both groups.
The bottom line
The authors concluded that safety, outcomes, and complications of HLE and PKE were similar for men with BPH and prostates larger than 60 mL. PKE required shorter operating, catheterization, and hospitalization times.
The fine print
The study was conducted in one hospital in France only. It also did not compare prostatic volumes after surgeries.
Published By :
World Journal of Urology
Date :
Jul 27, 2020
