In a nutshell
This review aimed to determine which method of laser technology, between PVP and HoLEP, was more effective for treating lower urinary tract symptoms in patients with small prostate volumes. The authors concluded that both methods were safe and effective forms of treatment.
Some background
In benign prostate hyperplasia, the prostate gland is enlarged, which causes the urethra (tube through which urine is excreted) to be partially blocked. This can result in lower urinary tract symptoms (problems with urination). New laser-based technology can be used to resolve these symptoms with less blood loss, shorter catheterization and shorter hospital stay then traditional surgical methods. In addition, patients with small prostate volume may not be suitable for surgery and could be better suited to laser technology. Examples of this technology include photoselective vaporization (PVP) and holmium laser enucleation (HoLEP). While both technologies have been shown to be effective in treating BPH, few studies compare the two methods directly.
Methods & findings
Data of small volume prostate patients with BPH from two hospitals was combined and analyzed. Patients had undergone either PVP or HoLEP to resolve BPH symptoms. In total, data from 338 patients was included, with 176 patients having had PVP and 162 patients having had HoLEP.
Qmax (amount of urine released from the body), PVR (urine left in the body after urination), IPSS (screen for symptoms of BPH) and QoL (quality of life) were measured before and after the procedure. Prior to treatment, both groups of patients had similar values of each.
No differences in effectiveness were found 12 months after treatment. Both groups of patients had improved symptoms and quality of life.
Complications from the procedures included urethral stricture (narrowing of the urethra), which occurred in 2.3% of PVP patients and 2.5% of HoLEP patients. Bladder neck contracture (narrowing of the bladder neck) occurred in 3.4% of the PVP patients and 1.2% of HoLEP patients.
The bottom line
The authors concluded that both PVP and HoLEP are equally safe and effective to relieve the symptoms of BPH in patients with small prostate volume.
Published By :
PLOS ONE
Date :
May 26, 2016
