Holmium laser versus transurethral resection of the prostate: A randomizedprospective trial with 1-year followup

Purpose: The high-powered holmium:YAG laser can be used for incision, ablat ion and resection of the prostate, The technique of holmium laser resection of the prostate is compared to transurethral prostatic resection for surgi cal management of benign prostatic hyperplasia in this prospective randomiz ed study. Materials and Methods: A total of 120 urodynamically obstructed cases were randomized to holmium laser or transurethral prostatic resection. All eligi ble patients were assessed preoperatively and at 3 weeks, and 3, 6 and 12 m onths postoperatively with an American Urological Association symptom score , peak urinary flow rate, and questionnaires concerning sexual function and continence. Preoperative pressure flow study, ultrasound prostate volume a ssessment and post-void residual volume measurement were repeated at the 6- month visit. All complications were noted. Results: Holmium laser and transurethral resections resulted in significant improvements in symptom score, quality of life score, peak urinary flow ra te and post-void residual. urine measurements. Operating time was significa ntly longer in the holmium group but nursing contact time, catheter time an d hospital stay were significantly less compared to the transurethral prost atic resection group. Urodynamic results were equivalent at 6 months. There were fewer side effects in the holmium group. Effects on continence, poten cy and symptoms were similar with 1-year followup. Conclusions: Holmium and transurethral resections of the prostate appear to be equivalent in surgical management of bladder outflow obstruction due to benign prostate hyperplasia. Peri-operative morbidity was less in the holm ium group.