Objectives: To compare the safety and efficacy of holmium laser enucleation of the prostate (HoLEP) and bipolar palsmakinetic enucleation of the prostate (BPEP) for patients with benign prostatic hyperplasia (BPH) and prostate volumes 50-120 mL.
Methods: a total of 52 patients were prospectively randomized and enrolled in this study at Zagazig university hospitals. All patients were preoperatively evaluated using prostate volume measurement, the International Prostate Symptom Scores (IPSS) questionnaire, a quality-of-life (QoL) questionnaire and international index for erectile function-5 (IIEF-5). Measurement of maximum urinary flow rate (Qmax), post-void residual urine volume (PVR) and blood sample analysis for determination of prostate-specific antigen (PSA) and haemoglobin concentration. Patients were evaluated peri-operatively and postoperatively at 1, 3, 6 and 12 months with documentation of any complication.
Results: Of 52 patients enrolled in this study, 47 patients completed 12 months of follow-up. There were statistically insignificant differences between both groups regarding the preoperative and intraoperative data. Perioperatively, bleeding, need for blood transfusion and hemoglobin drop were higher in the HoLEP group. There were no statistically significant differences in the post-operative follow-up data between both groups.
Conclusion: In terms of surgical safety and efficacy BPEP is comparable to HoLEP for moderately to markedly enlarged prostates, with indication for surgical intervention.