Clinical Study On Low-Powered Holmium Laser Enucleation Of The Prostate

ObjectiveTo compare the safety and efficacy of Low-powered Holmium Laser Emuclation of the Prostate(LP-HoLEP)with plamakinetic resection of prostate(PKRP)in patients with benign prostatic hyperplasia.MethodsAll 228 patients with BPH underwent LP-HoLEP(n=112)or PKRP(n=116)between June 2015 and June 2017.The operative time,drop in hemoglobin,drop in sodium,hospital stay,irrigated volume,irrigated time,indwelling catheterization time and operative complications were recorded.All patients were followed up for 6months.In preoperative and postoperative 3,6 months,International prostate symptom score(IPSS),quality of life(QoL),urinary peak flow rate(Qmax),post-voiding residual urine(PVR)and International Index of Erectile Function(IIEF-5)were also compared.ResultsThere is no significant difference between LP-HoLEP group and PKRP group in preoperative data,included age,prostate volume,PSA level,IPSS,Qmax,QoL,PVR,IIEP-5(p>0.05).There is also no significant difference in the operative time between the two groups.Compared with PKRP,LP-HoLEP required slightly longer operation time(61.3 vs 57.4 min,p<0.05),but the LP-HoLEP group had operative time including prostatectomy time and prostate crush time.There is no TUR syndrome(TURS)after surgery in both groups.However,LP-HoLEP was significantly superior to PKRP in terms of volume of resected prostate fluid,amount of irrigation fluid,intraoperative blood loss,bladder irrigation time,postoperative catheter indwelling time,and length of hospital stay(p<0.05).After 6 months of follow-up,the follow-up results are significantly improved compared with preoperative Qmax,PVR,IPSS,QOL at 3 and 6 months after surgery in the two groups(P<0.05),but there is no statistical difference between the groups(p>0.05).ConclusionsDuring the 6-month follow-up,LP-HoLEP and PKRP can significantly improvethe patient's Qmax and reduce the patient's IPSS,QoL and PVR.However,both procedures showed no significant difference in terms of Qmax,IPSS,PVR,and QoL.So,LP-HoLEP and PKRP are significant efficacy and safety in treating BPH.In terms of surgical efficiency,the operative time was not significantly different between the two groups.The LP-HoLEP group had a slightly longer operative time but was similar to the high-power HoLEP.However,the operative time in the LP-HoLEP group included the prolapse time of the prostate and the crushing and absorption of the prostate time.However,compared with PKRP,LP-HoLEP has a longer learning curve,but it has less intraoperative blood loss,shorter indwelling catheter time,shorter hospital stay,less flush fluid volume,and no Limited to the size of the prostate volume and other advantages.For experienced surgeons,power is less relevant than technique.In conclusion,LP-HoLEP is technically feasible,safe and effective for the treatment of BPH.