Randomized comparison of transurethral electroresection and Holmium : YAG laser vaporization for symptomatic benign prostatic hyperplasia

Objective: To evaluate the safety and efficacy of holmium:YAG laser vaporiz ation v transurethral electroresection (TURP) for benign prostatic hyperpla sia. Patients and Methods: Thirty-six patients were randomized. Two laser proced ures (60 to 80 W) were performed for one TURF. Symptom Score, peak flow rat e, potency, and ejaculation status were measured at baseline and at 1, 3, 6 , and 12 months. Results: The mean operative time was 75 minutes for laser and 56 minutes fo r TURF (P = 0.0407). With a mean laser energy delivered of 103.6 kJ, hemost asis was satisfactory during vaporization. The mean catheterization time wa s 1.7 and 2.1 days in the laser and TURF group, respectively. For the laser and TURF groups, the mean AUA Score improved from 20 preoperatively to 7 a nd from 24.1 to 5, respectively, at 12 months. The mean peak flow increased from 8.4 to 19.5 mL/sec and from 7.6 to 16.8 ml/sec, respectively, at 12 m onths. These results are not statistically different. No significant initia l dysuria occurred. No significant difference between the groups appeared i n potency or ejaculatory status during the follow-up. One patient in the la ser group (Day 5) and two in the TURF group (2nd and 6th month) had to unde rgo a second procedure to relieve obstruction. Conclusion: Although taking slightly longer to accomplish, holmium:YAG lase r vaporization of BPH provides early results very similar to those of TURF with a shorter catheterization time and no initial dysuria or pain.