Minimally Invasive Techniques for Large-Volume Benign Prostatic Hyperplasia: A Comparative Study Between HoLEP and Robotic Simple Prostatectomy
<b>Background/Objectives</b>: The aim of this research was to compare perioperative outcomes, functional results, quality of life, and complications between robot-assisted simple prostatectomy (RASP) and holmium laser prostate enucleation (HoLEP) as minimally invasive techniques for trea...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-05-01
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| Series: | Surgical Techniques Development |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2038-9582/14/2/17 |
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| Summary: | <b>Background/Objectives</b>: The aim of this research was to compare perioperative outcomes, functional results, quality of life, and complications between robot-assisted simple prostatectomy (RASP) and holmium laser prostate enucleation (HoLEP) as minimally invasive techniques for treating benign prostatic hyperplasia (BPH) in large prostates (>150 cm<sup>3</sup>). <b>Methods</b>: This retrospective, multicenter, observational study (2007–2023) included patients with >150 cm<sup>3</sup> prostate volumes who underwent either HoLEP or robot-assisted prostatectomy. Primary outcomes: success rate (complete enucleation, without transfusion or reintervention), good postoperative quality of life (IPSS 8th question score: 0–2), and continence at 6 months (no pads). Secondary outcomes: operative and catheterization time, hospital stay, enucleated gland weight, PSA reduction, Qmax improvement, and perioperative complications. <b>Results</b>: We included 95 HoLEP and 50 RASP patients with similar demographics and prostate volume (HoLEP: 187.72 cm<sup>3</sup>; RASP: 203.38 cm<sup>3</sup>). The success rate (HOLEP: 83.2%; RASP: 74%), continence rate (HoLEP: 85.1%; RASP: 86%), and quality of life (HoLEP: 83.2%; RASP 94%) were similar (<i>p</i> = 0.275, <i>p</i> = 1, and <i>p</i> = 0.075, respectively). HoLEP had a shorter operative time (97.58 vs. 122.4 min) and catheterization duration, with similar hospitalization duration (HoLEP: 3.46 days; RASP: 4.22 days). Although there was no significant difference in enucleated gland weight, HoLEP was more efficient (1.28 g/min vs. 1.06 g/min). Complication rates were similar (HOLEP: 15.5%; RASP: 26%; <i>p</i> = 0.12). <b>Conclusions</b>: Both RASP and HoLEP are safe for treating BPH in prostates >150 cm<sup>3</sup>, reporting similar success and continence rates and good quality of life after surgery. However, HoLEP achieved results with shorter operative time and catheterization duration. |
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| ISSN: | 2038-9582 |