HoLEP, RASP deliver equally excellent postoperative outcomes in benign prostatic hyperplasia

The use of holmium laser enucleation of the prostate (HoLEP) and robotic-assisted simple prostatectomy (RASP) deliver comparable and good postoperative outcomes in patients with large benign prostatic hyperplasia (BPH), a new study has found.

Researchers conducted a retrospective assessment of 59 men who had received either HoLEP (n=26) or RASP (n=33) for BPH. Postoperative outcome measures included change in the International Prostatic Symptom Score (IPSS), need for transfusion, length of hospital stay, complication, and uroflowmetry and haemoglobin.

After the procedure, there were no significant between-group differences in terms of improvement in prostate-specific antigen (PSA; 6.39 vs 4.66 ng/mL; p=0.14); IPSS obstructive (9.4 vs 10.9; p=0.29) and irritative (1.9 vs 3.8; p=0.11) scores; and quality of life (2.2 vs 2.0; p=0.79). Postoperative maximum flow rate (13.2 vs 13.4 mL/s; p=0.92) and post-void residual urine (98.9 vs 127.2 mL; p=0.38) were comparable between treatments.

Similarly, baseline demographic characteristics, such as age (p=0.26), preoperative levels of PSA (p=0.11), total prostate volume (p=0.14), and transitional volume (p=0.18) were similar between groups. The same was true for other operative parameters such as operation time (p=0.42) and resected volume (p=0.26).

In contrast, HoLEP led to a significantly shorter catheter removing time (7.0 vs 2.5 days; p<0.01) and length of hospital stay (7.1 vs 2.5 days; p<0.01), while RASP patients saw a better postoperative incontinence profile. “These factors must be heavily considered during the selection of surgical method for large prostate,” the researchers said.