A Randomized Trial Comparing Diode Laser Enucleation of the Prostate with Plasmakinetic Enucleation and Resection of the Prostate for the Treatment of Benign Prostatic Hyperplasia
Xu A, Zou Y, Li B, Liu C, Zheng S, Li H, Xu Y, Chen B, Xu K, Shen H. J Endourol. 2013 Jul 23. [Epub ahead of print]

Source

Institution of Urology, Department of Urology, Zhujiang Hospital, Souther Medical University, Guangzhou, Guangdong, China ; lc96xab@163.com.

Abstract

Ojectives We compared the safety and efficacy of diode laser enucleation of the prostate (DiLEP) with plasmakinetic enucleation and resection of the prostate (PKERP). Methods A total of 80 patients with bladder outflow obstruction (BOO) due to Benign Prostatic Hyperplasia (BPH) were randomly assigned to either DiLEP or PKERP prospectively. All patients were assessed preoperatively and followed up at 3, 6, 12 months postoperatively. Baseline characteristics of the patients, perioperative data, and postoperative outcomes were compared. The operative data, peri- and post-operative complications were also recorded. Results The preoperative data were comparable between the two groups. The DiLEP group had significantly shorter operative time, postoperative irrigation time and catheterization time than PKERP group (p=0.000, p=0.000 and p=0.000). The drop in hemoglobin was statistically significantly less in the DiLEP group (p=0.002). There were no statistical differences in complications between the two groups except irritative symptoms (p=0.018). At the 3, 6, 12-month follow-up, no statistically significant differences were observed between the 2 groups in IPSS, Qmax, QOL, PVR, PV and PSA (p>0.05). Conclusions The efficacy of DiLEP and PKERP were similar for relieving obstruction and low urinary tract symptoms. DiLEP provides less risk of hemorrhage, reduced bladder irrigation and catheter times. Downward morcellation technique is more efficient than the resection technique. Future well designed randomized trials with extended follow-up and larger sample sizes may be needed to better verified the advantage of DiLEP in treating patients with symptomatic BPH.