title: Outcomes of transurethral resection and holmium laser enucleation in more than 60 g of prostate: A prospective randomized study.
abstract: OBJECTIVE
  Transurethral resection of prostate (TURP) is considered a gold standard surgical procedure. The management of benign prostatic hyperplasia (BPH) has undergone tremendous change in recent years and shifted from open to minimal invasive procedure. With the advancement in technology and skills of surgeons, lasers have been used more liberally, particularly holmium laser. Holmium laser enucleation of prostate (HoLEP) is seen as close rival of TURP. The objective if this study is to observe long- and short-term outcomes of transurethral resection and holmium laser enucleation in the prostate of more than 60 g.
  
  
  METHODS
  This prospective randomized study includes 164 patients. Inclusion criteria were age <75 years after failed or poor response to medical therapy, prostatic size >60 g, gross hematuria secondary to BPH, recurrent urinary tract infection, acute urinary retention, postvoid residual >150 ml, and Schafer Grade II or more. BPH associated with neurogenic bladder, stricture urethra, and carcinoma prostate were excluded from the study. Group 1 comprises patients who underwent TURP and Group 2 comprises who underwent HoLEP. Follow-up was done at 1, 3, 6, 12, and 24 months after the surgery.
  
  
  RESULTS
  Data of 144 patients were analyzed. The mean age of patients in TURP and HoLEP group was 66.78 ± 7.81 and 67.70 ± 7.44 years, respectively (P= 0.47), mean prostatic volume was 74.5 ± 12.56 and 75.6 ± 12.84 g, respectively (P= 0.60), operative time was 73.10 ± 10.49 and 89.56 ± 13.81 min, respectively (P= 0.0001). Mean resected tissue was 44.80 ± 9.87 and 48.49 ± 10.87, respectively (P= 0.03). The sexual function did not changed significantly in postoperative follow-up.
  
  
  CONCLUSIONS
  HoLEP is associated with less blood loss, lower transfusion rates, and a shorter hospital stay. The disadvantage of HoLEP is longer operative time and postoperative dysuria.
authors.affiliation: Department of Urology, King George's Medical College, Lucknow, Uttar Pradesh, India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Jhanwar
authors.affiliation: Department of Urology, King George's Medical College, Lucknow, Uttar Pradesh, India.
authors.forename: Rahul J
authors.initials: RJ
authors.lastname: Sinha
authors.affiliation: Department of Urology, King George's Medical College, Lucknow, Uttar Pradesh, India.
authors.forename: Ankur
authors.initials: A
authors.lastname: Bansal
authors.affiliation: Department of Urology, King George's Medical College, Lucknow, Uttar Pradesh, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Prakash
authors.affiliation: Department of Urology, King George's Medical College, Lucknow, Uttar Pradesh, India.
authors.forename: Kawaljit
authors.initials: K
authors.lastname: Singh
authors.affiliation: Department of Urology, King George's Medical College, Lucknow, Uttar Pradesh, India.
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Singh
keywords: Holmium laser enucleation of prostate; prostate; transurethral resection of prostate