Both holmium laser enucleation of the prostate (HoLEP) and photoselective laser vaporisation of the prostate (PVP) are comparably safe and effective as treatments for benign prostatic hyperplasia (BPH). However, data from a prospective randomised trial suggests that the long-term outcomes of HoLEP surgery may be better.
Dr Yan-Bo Chen (Shanghai Jiao Tong University, China) presented a study that directly compared 2 different laser systems which each produce different qualitative and quantitative effects in tissue . The primary outcome was perioperative safety and 24-month follow-up efficacy data.
A total of 314 BPH patients (estimated prostate volume <60 mL, urodynamics-confirmed BPH) were randomly assigned 1:1 to receive either HoLEP or PVP. Operating times were longer for the patients receiving HoLEP (median 52.3±12.2 minutes) compared with PVP (46.6±12.0 minutes; P<0.001). There was no significant difference in the success rate of removal of the catheter between the 2 groups within 24 hours after operation (HoLEP 94.9% vs PVP 96.2%; P>0.05). Both groups displayed significant improvements in prostate volume after the surgery, although the reduction observed with HoLEP was significantly better when measured at 6 months and 24 months post-intervention (see Table). There were no differences between the 2 arms in outcomes of the international prostate symptom score (IPSS), quality of life (QoL), or peak urinary flow rate (Qmax) values (all P>0.05). The reoperation rate in the HoLEP group was significantly lower with 24-month follow-up (0% vs 3.8%; P=0.013), although the rate of transient incontinence was higher in the HoLEP group (8.3% vs 2.5%; P=0.025). Collectively, these results slightly favour HoLEP over PVP, although validation of this study is still warranted.
Table: Baseline and follow-up data 
IPSS, international prostate symptom score; HoLEP, holmium laser enucleation of the prostate; PVP, photoselective laser vaporisation of the prostate; QoL, quality of life; Qmax, peak urinary flow rate; PV, prostate volume.
- Chen YB, et al. EAU20 Virtual Congress, 17-26 July 2020, Abstract 831.
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Table of Contents: EAU 2020
Letter from the Editor
EAU 2020 Highlights Podcast
Surgical Techniques and Safety
The new adjustable artificial sphincter victo: Surgical technique and results after a follow-up of more than one year
New urosepsis data from the SERPENS study
Intra-operative cone-beam computed tomography for detecting residual stones in percutaneous nephrolithotomy
Pressure and temperature: do high-power lasers pose a threat?
Radiation stewardship for patient and endourologist
New lithotripter data: improved stone clearance
Beyond the limits of ultrasound: Three dimensional augmented reality robot assisted partial nephrectomy (3D AR-RAPN) for complex renal masses
Imaging guided surgery with augmented reality for robotic partial nephrectomy
KEYNOTE-426: no QoL differences pembrolizumab + axitinib versus sunitinib
Debate: upfront cytoreductive nephrectomy or not?
Robotic-assisted partial nephrectomy: lower morbidity
Reduced BCG frequency, faster NMIBC recurrence
Nadofaragene firadenovec effective in BCG-unresponsive papillary NMIBC
Understanding MIBC biology for novel treatment options
Prostate Cancer & Imaging
Transperineal laser ablation of prostate
Prostatectomy: R-LRPE better than LRPE for continence
PSMA PET-CT staging is 27% more accurate
Docetaxel + hormonal therapy: improved prostate cancer PFS
ARAMIS subgroup analysis: darolutamide benefits across PSADT groups
Large patient-driven survey reveals QoL issues after prostate cancer treatment
Targeting steroid sulphatase in resistant prostate cancer cells
Good tolerance of post-RP radiotherapy ± short-term ADT
BPH & LUTS
Minimizing post-operative stress urinary incontinence after HoLEP: Our preliminary experience and short-term results of ‘’En Bloc’’ technique with early apical release
LUTS 2-year outcomes: aquablation versus TURP
HoLEP versus PVP in prospective randomised trial
LUTS in the neuro-urologic patient
Testis Cancer & Andrology
Peyronie’s disease: surgical options
Infertility and testis cancer risk: causal or association?
32% more men complain of reduced sex drive in 2019 versus 2009
Focus on kidney: End of monotherapy