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BPH

HoLEP—a steep learning curve but better for patients

Nature Reviews Urology volume 10, page 66 (2013)Cite this article

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A new prospective trial has shown that holmium laser enucleation of the prostate (HoLEP) is associated with a lower risk of haemorrhage and shorter postprocedure bladder irrigation time than bipolar transurethral resection of the prostate (TURP), the current gold standard.

Despite these similarities, the perioperative data were different between the two groups, which might have some important implications for patients and surgeons. For example, patients in the HoLEP group required shorter periods of bladder irrigation to resolve haematuria than the men who underwent TURP. Also, the amount of material removed from the prostate was considerably higher in men who had HoLEP, which was reflected in a sharper drop in PSA levels after surgery. “HoLEP broadens the scope of minimally invasive treatments for men with BPH,” lead investigator Zhong Wang explains. “HoLEP can be combined with mechanical morcellation, we can expose the surgical capsule easily and, importantly, treat even very large prostates.” TURP, by contrast, is associated with a higher risk of bleeding when treating very enlarged prostates.

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References

ORIGINAL RESEARCH PAPER

  1. Chen, Y.-B. et al. A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup. J. Urol. 189, 217–222 (2013)

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FURTHER READING

  1. van Rij, S. & Gilling, P. J. In 2013, holmium laser enucleation of the prostate (HoLEP) may be the new 'gold standard'. Curr. Urol. Rep. 13, 427–432 (2012)

    Article  PubMed  Google Scholar 

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Authors
  1. Mina Razzak
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Razzak, M. HoLEP—a steep learning curve but better for patients. Nat Rev Urol 10, 66 (2013). https://doi.org/10.1038/nrurol.2012.236

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