Dr Yan-Bo Chen (Shanghai Jiao Tong University, China) presented a study that directly compared 2 different laser systems which each produce different qualitative and quantitative effects in tissue [1]. The primary outcome was perioperative safety and 24-month follow-up efficacy data.
A total of 314 BPH patients (estimated prostate volume <60 mL, urodynamics-confirmed BPH) were randomly assigned 1:1 to receive either HoLEP or PVP. Operating times were longer for the patients receiving HoLEP (median 52.3±12.2 minutes) compared with PVP (46.6±12.0 minutes; P<0.001). There was no significant difference in the success rate of removal of the catheter between the 2 groups within 24 hours after operation (HoLEP 94.9% vs PVP 96.2%; P>0.05). Both groups displayed significant improvements in prostate volume after the surgery, although the reduction observed with HoLEP was significantly better when measured at 6 months and 24 months post-intervention (see Table). There were no differences between the 2 arms in outcomes of the international prostate symptom score (IPSS), quality of life (QoL), or peak urinary flow rate (Qmax) values (all P>0.05). The reoperation rate in the HoLEP group was significantly lower with 24-month follow-up (0% vs 3.8%; P=0.013), although the rate of transient incontinence was higher in the HoLEP group (8.3% vs 2.5%; P=0.025). Collectively, these results slightly favour HoLEP over PVP, although validation of this study is still warranted.
Table: Baseline and follow-up data [1]

IPSS, international prostate symptom score; HoLEP, holmium laser enucleation of the prostate; PVP, photoselective laser vaporisation of the prostate; QoL, quality of life; Qmax, peak urinary flow rate; PV, prostate volume.
- Chen YB, et al. EAU20 Virtual Congress, 17-26 July 2020, Abstract 831.
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