This study compared the safety and effectiveness of two minimally invasive surgical procedures used to treat benign prostatic hyperplasia (BPH).

Researchers concluded that HoLEP (a type of laser surgery) is a safe and effective treatment for BPH and can be considered as a suitable alternative to other surgical procedures. 

BPH can lead to bothersome symptoms that can impact quality of life and challenge everyday activities. Surgery is often required to remove the enlarged prostate tissue. A minimally invasive procedure called transurethral resection of the prostate (TURP) is the current standard-of-care. TURP allows for the destruction of prostate tissue through a wire loop inserted into the urethra (the penile opening).

More recently developed surgical procedures include the laser technique HoLEP (short for holmium laser enucleation of the prostate) and a variation to the TURP procedure, called bipolar TURP (TURPb). Both have been associated with less complications and faster recovery time than the standard-of-care TURP procedure. This study directly compared effects and safety of HoLEP and TURPb.

120 men with BPH were randomly assigned to receive treatment with either HoLEP or TURPb. Surgical outcomes were compared and followed-up for one year.

Both surgical procedures were safe and well tolerated by the patients. While the average surgery time was longer for HoLEP than for TURPb, surgery outcomes were generally more favorable. Improvements in urinary symptoms (in terms of complete emptying of the bladder) were significantly greater in men undergoing treatment with HoLEP. This difference was maintained at one-year follow-up. Blood loss during surgery, and catheter use after surgery, were also reduced in men undergoing HoLEP.

The researchers concluded that HoLEP is a safe and effective surgical procedure to treat enlarged prostates. 

This study did not control for prostate size. Larger studies comparing these preliminary findings across different prostate sizes are needed.