Comparative Analysis of the Effectiveness of Modern Endoscopic Methods of Treatment of BPH
Downloads
Lower urinary tract symptoms caused by benign prostatic hyperplasia are the most common urological problem among men, affecting about a third of men over the age of 50
Of all surgical treatments, monopolar transurethral resection of the prostate (TURP), in which enlarged prostate tissue is resected piece by piece using a monopolar electrode, has been the standard method since the 1970s. It can significantly improve maximum flow rate (Qmax), urination-related symptoms (based on the International Prostate Symptom Assessment Scale (IPSS)), and health-related quality of life with long-term efficacy compared to medications or other minimally invasive treatments [4].
Since the 2000s, new energy systems for surgery for benign prostatic hyperplasia have rapidly become popular, including systems using bipolar energy and various laser systems such as holmium laser, potassium titanyl phosphate (KTP) laser, thulium laser and diode laser Over the past 10 years, the trend in the surgical treatment of benign prostatic hyperplasia has shifted from monopolar TURP to laser therapy and bipolar TURP. Based on the data on the effectiveness of the HoLEP technique, it becomes clear that HoLEP is ready to replace all these methods as a new standard, based on almost two decades of data that consistently demonstrate its better results and lower complication rate. This review summarizes the available literature by comparing HoLEP and traditional BPH treatments that are widely used and have long-term efficacy data.
Despite the fact that there is such a wide arsenal of surgical treatment of BPH, each of these methods has its own advantages and disadvantages. This review article contains a significant portion of the best randomized data directly comparing HoLEP with alternative surgical treatments.
Roehrborn CG. Benign prostatic hyperplasia: an overview. Rev Urol 2005;7(Suppl 9):S3–s14
Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003; 61:37–49.
Malaeb BS, Yu X, McBean AM, Elliott SP. National trends in surgical therapy for benign prostatic hyperplasia in the United States (2000-2008). Urology2012;79:1111-6. doi:10.1016/j.urology.2011.11.084 pmid:22546389
Reich O, Seitz M, Gratzke C, Schlenker B, Walther S, Stief C[Benign prostatic hyperplasia (BPH): Surgical therapy options]. Urologe A2010;49:113-26.
doi:10.1007/s00120-009-2183-1 pmid:20033128
Issa MMTechnological advances in transurethral resection of the prostate: bipolar versus monopolar TURP.Endourol. 2008;22:158795.
doi:10.1089/end.2008.0192 pmid:18721041.
Grande M, Facchini F, Moretti M, et al[History of laser in BPH therapy]. Urologia2014;81 (Suppl23): S3842. doi:10.5301/RU.2014.11985 pmid:24665033
Vincent MW, Gilling PJ. HoLEP has come of age. World J Urol 2015; 33: 487-93.
Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, Speakman MJ, Stief CG. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol 2010; 58: 384-397
Yin L, Teng J, Huang CJ, Zhang X, Xu D. Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a systematic review and meta-analysis of randomised controlled trials. J Endourol 2013; 27: 604-611
Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 2012; 109: 408-411
Humphreys MR, Miller NL, Handa SE, Terry C, Munch LC, Lingeman JE. Holmium Laser Enucleation of the Prostate-Outcomes Independent of Prostate Size? J Urol 2008; 180: 2431-5.
Kuntz RM, Lehrich K, Ahyai S. Does perioperative outcome of transurethral holmium laser enucleation of the prostate depend on prostate size? J Endourol 2004; 18: 183-8.
Kuntz RM, Lehrich K, Ahyai SA. Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 2008; 53: 160-166.
Naspro R, Suardi N, Salonia A, Scattoni V, Guazzoni G, Colombo R, Cestari A, Briganti A, Mazzoccoli B, Rigatti P, Montorsi F. Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 2006; 50: 563-8.
Moody JA, Lingeman JE. Holmium laser enucleation for prostate adenoma greater than 100 gm.: comparison to open prostatectomy. J Urology 2001; 165: 459-62.
Chung DE and Te AE. High-power 532 nm laser prostatectomy: an update. Curr Opin Urol 2010; 20: 13-9
Elmansy H, Baazeem A, Kotb A, Badawy H, Riad E, Emran A, Elhilali M. Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial. J Urol 2012; 188: 216-21.
Chen YB, Chen Q, Wang Z, Peng YB, Ma LM, Zheng DC, Cai ZK, Li WJ, Ma LH. A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year follow up. J Urol 2013; 189: 217-222.
Neill MG, Gilling PJ. Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia. Urology 2006; 68: 1020-4.
Zhang F, Shao Q, Herrmann TR, Tian Y, Zhang Y. Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single centre. Urology 2012; 79: 869-874
Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 2012; 109: 408-411
22) Hamouda A, Morsi G, Habib E, Hamouda H, Emam AB, Etafy M. A comparative study between holmium laser enucleation of the prostate and transurethral resection of the prostate: J Clin Urol. 2016;7:99–104.
23) Jhanwar A, Sinha RJ, Bansal A, Prakash G, Singh K, Singh V. Outcomes of transurethral resection and holmium laser enucleation in more than 60 g of prostate: a prospective randomized study. Urol Ann. 2017;9:45–50.
24) Bozzini G, Seveso M, Melegari S, de Francesco O, Buffi NM, Guazzoni G, et al. Thulium laser enucleation (ThuLEP) versus transurethral resection of the prostate in saline (TURis):. Actas Urol Esp (Engl Ed). 2017;41:309–15.
25) Yang Z, Liu T, Wang X. Comparison of thulium laser enucleation and plasmakinetic resection of the prostate in a randomized prospective trial with 5-year follow-up. Lasers Med Sci. 2016;31:1797–802.
All Content should be original and unpublished.
