Different surgical techniques for BPH – what do the patients say?

This study compared outcomes of different surgical techniques used to treat BPH, as reported by the patients.

Researchers concluded that all procedures are associated with high patient satisfaction. HoLEP was found to be associated with the best results for treatment outcome, quality of life and overall satisfaction, according to patient reports.

Benign prostatic hyperplasia (BPH) can lead to bothersome symptoms that often require surgery to remove enlarged prostate tissue. Over the past decade, less invasive surgical procedures have been developed. A minimally invasive procedure called transurethral resection of the prostate (TURP) is the current standard-of-care. Other procedures commonly used include laser techniques such as HoLEP (short for holmium laser enucleation of the prostate), PVP (short for photoselective vaporization of the prostate), transurethral incision of the prostate (TUIP) and open surgery (prostatectomy).

This study directly compared surgical techniques and their outcomes as seen from the patient’s perspective. 479 men completed a questionnaire covering urinary and sexual symptoms, quality of life as well as overall satisfaction after surgery.

Overall patient satisfaction was good across all surgical techniques. Patient satisfaction was highest among men undergoing HoLEP. 64% of men who underwent HoLEP said that they would choose the same procedure again, compared to 47% of patients that underwent TURP.

Urinary symptoms after surgery were, on average, most reduced among men who underwent open prostate surgery, followed by HoLEP. Men that underwent HoLEP reported the greatest improvement in specific urinary symptoms including less straining, better emptying of the bladder and a stronger urine stream. HoLEP was also associated with the greatest overall improvement in quality of life. Incontinence symptoms were most reduced following TURP. There were no differences in sexual symptoms across surgical techniques.

Researchers concluded that all current prostate procedures are associated with high levels of patient satisfaction. HoLEP was found to be associated with the best results for treatment outcome, quality of life and overall satisfaction, according to patient reports.

Most patients included in this study underwent HoLEP or TURP. The number of patients undergoing other surgical techniques was very low and should, therefore, be considered separately.