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document
A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams : results at 2 years . OBJECTIVE To compare holmium laser enucleation of the prostate ( HoLEP ) with transurethral resection of the prostate ( TURP ) for treatment of men with bladder outflow obstruction ( BOO ) secondary to benign prostatic hyperplasia with a minimum of 24-month follow-up . PATIENTS AND METHODS Sixty-one patients were randomised to either HoLEP or TURP . All patients had BOO proven on urodynamic studies pre-operatively ( prostate size 40-200 g ) . One patient died before treatment , which left 30 patients in each group . Perioperative data , as well as symptom scores , Quality of Life ( QoL ) scores , and maximum urinary flow rates ( Qmax ) were obtained at one , three , six,12 , and 24 months . Post-void residual volumes , transrectal ultrasound ( TRUS ) volumes , and pressure flow studies were obtained six months post-operatively . Continence and potency data were also recorded . RESULTS There were no significant differences between the two surgical groups pre-operatively . Mean pre-operative TRUS volume was 77.8+/-5.6 g ( 42-152 ) in the HoLEP group and 70.0+/-5.0 g ( 46-156 ) in the TURP group . Patients in the HoLEP group had shorter catheter times and hospital stays . More prostate tissue was retrieved in the HoLEP group . At six months , HoLEP was urodynamically superior to TURP in relieving BOO . At 24 months , there was no significant difference between the two surgical groups with respect to American Urology Association scores , QoL scores , or Qmax values ; however , two patients in the TURP group required re-operation . CONCLUSIONS HoLEP has less perioperative morbidity and produces superior urodynamic outcomes than TURP , when treating prostates > 40 g. At 24 months of follow-up , HoLEP is equivalent to TURP .
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Intervention_Surgical
holmium laser enucleation
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Intervention_Surgical
transurethral resection
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Intervention_Surgical
holmium laser enucleation of the prostate ( HoLEP )
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Intervention_Surgical
transurethral resection of the prostate ( TURP )
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Intervention_Surgical
HoLEP
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Intervention_Surgical
TURP
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Intervention_Surgical
TURP
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Intervention_Surgical
HoLEP
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Intervention_Surgical
HoLEP
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Intervention_Surgical
HoLEP
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Intervention_Surgical
TURP
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Intervention_Surgical
HoLEP
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Intervention_Surgical
TURP
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Intervention_Surgical
HoLEP
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Intervention_Surgical
TURP
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Outcome_Physical
Perioperative data , as well as symptom scores , Quality of Life ( QoL ) scores , and maximum urinary flow rates ( Qmax )
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Outcome_Physical
Post-void residual volumes , transrectal ultrasound ( TRUS ) volumes , and pressure flow studies
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Outcome_Physical
Continence and potency data
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Outcome_Physical
Mean pre-operative TRUS volume
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Outcome_Other
catheter times
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Outcome_Other
hospital stays
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Outcome_Physical
prostate tissue
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Outcome_Physical
urodynamically
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Outcome_Physical
American Urology Association scores , QoL scores , or Qmax values
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Outcome_Physical
urodynamic outcomes
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Participant_Condition
prostates larger than 40 grams
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Participant_Sex
men
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Participant_Condition
bladder outflow obstruction ( BOO )
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Participant_Condition
benign prostatic hyperplasia
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Participant_Condition
BOO
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Participant_Condition
prostate size 40-200 g