title: Comparison of Surgical Outcomes Between Holmium Laser Enucleation and Transurethral Resection of the Prostate in Patients With Detrusor Underactivity.
abstract: OBJECTIVE
  Currently, holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP) are the standard surgical procedures used to treat benign prostatic hyperplasia (BPH). Several recent studies have demonstrated that the surgical management of BPH in patients with detrusor underactivity (DU) can effectively improve voiding symptoms, but comparative data on the efficacy of HoLEP and TURP are insufficient. Therefore, we compared the short-term surgical outcomes of HoLEP and TURP in patients with DU.
  
  
  METHODS
  From January 2010 to May 2015, 352 patients underwent HoLEP or TURP in procedures performed by a single surgeon. Of these patients, 56 patients with both BPH and DU were enrolled in this study (HoLEP, n=24; TURP, n=32). Surgical outcomes were retrospectively compared between the 2 groups. DU was defined as a detrusor pressure at maximal flow rate of <40 cm H2O as measured by a pressure flow study.
  
  
  RESULTS
  The preoperative characteristics of patients and the presence of comorbidities were comparable between the 2 groups. The TURP group showed a significantly shorter operative time than the HoLEP group (P=0.033). The weight of the resected prostate was greater in the HoLEP group, and postoperative voiding parameters, including peak flow rate and postvoid residual urine volume were significantly better in the HoLEP group than in the TURP group.
  
  
  CONCLUSIONS
  HoLEP can be effectively and safely performed in patients with DU and can be expected to have better surgical outcomes than TURP in terms of the improvement in lower urinary tract symptoms.
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Myeong Jin
authors.identifier: 0000-0002-3567-0616
authors.initials: MJ
authors.lastname: Woo
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Yun-Sok
authors.identifier: 0000-0003-3732-9814
authors.initials: YS
authors.lastname: Ha
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jun Nyung
authors.identifier: 0000-0002-6342-9846
authors.initials: JN
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Bum Soo
authors.identifier: 0000-0002-4873-3049
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Hyun Tae
authors.identifier: 0000-0002-4730-3776
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Tae-Hwan
authors.identifier: 0000-0003-4924-4826
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Eun Sang
authors.identifier: 0000-0002-7442-6886
authors.initials: ES
authors.lastname: Yoo
keywords: Holmium; Lasers; Prostatic Hyperplasia; Transurethral Resection of Prostate