Comparison of the efficacy of HoLEP and TURP in the treatment of elderly benign prostatic hyperplasia patients: a retrospective study

Abstract

Objective To prove that holmium laser prostatectomy (HoLEP) is safe and effective in the treatment of benign prostatic hyperplasia (BPH), and is superior to transurethral prostatectomy (TURP) for elderly patients.

Methods We retrospectively studied 565 HoLEP patients and 76 TURP elderly patients. HoLEP patients were first divided into three groups according to their age(Under 65 years old group, 65–79 years old group and over 80 years old group), and their preoperative, intraoperative, and postoperative characteristics were then compared. Secondly, the same characteristics of HoLEP and TURP patients over 80 years were compared. Chi-square test, one-way ANOVA and Fisher’s exact test were used in this study.

Results Firstly, we compared HoLEP patients in different age groups and found that there was statistically significant difference in diabetes, CCVD and bladder stones, among the three groups (P<0.05).

Secondlye, we compared HoLEP and TURP treatments in elderly patients (≥80 years old). The patients with HoLEP had a higher share of diabetes, CCVD and anticoagulation (P<0.05). Moreover, compared with TURP patients, HoLEP patients had shorter enucleation duration, more enucleate prostate weight, fewer hemoglobin diminutions, shorter bladder irrigation time, shorter catheter-indwelling period, and shorter hospital period (P<0.05). Although there was no difference in IPSS, Qmax and QOL between the two groups before operation (P>0.05), the difference was statistically significant, 6 months after the operation (P<0.05).

Conclusion HoLEP is safe and effective for BPH patients, and is superior to transurethral TURP for elderly patients.

Zusammenfassung

Zielsetzung Es sollte nachgewiesen werden, dass die Holmium-Laser-Prostatektomie (HoLEP) bei der Behandlung der benignen Prostatahyperplasie (BPH) sicher und wirksam ist und der transurethralen Prostatektomie (TURP) bei älteren Patienten überlegen ist.

Methoden Wir haben retrospektiv 565 HoLEP-Patienten und 76 ältere TURP-Patienten untersucht. Die HoLEP-Patienten wurden zunächst nach ihrem Alter in drei Gruppen eingeteilt (die Gruppe der unter 65-Jährigen, die Gruppe der 65–79-Jährigen und die Gruppe der über 80-Jährigen), und dann wurden ihre präoperativen, intraoperativen und postoperativen Merkmale verglichen. Zweitens wurden die gleichen Merkmale von HoLEP- und TURP-Patienten über 80 Jahren verglichen. In dieser Studie wurden der Chi-Quadrat-Test, die einseitige ANOVA und der exakte Test von Fisher verwendet.

Ergebnisse Erstens verglichen wir HoLEP-Patienten in verschiedenen Altersgruppen und stellten fest, dass es einen statistisch signifikanten Unterschied bei Diabetes, CCVD und Blasensteinen zwischen den 3 Gruppen gab (P<0,05).

Zweitens verglichen wir HoLEP- und TURP-Behandlungen bei älteren Patienten (≥80 Jahre alt). Die Patienten mit HoLEP hatten einen höheren Anteil an Diabetes, CCVD und Antikoagulation (P<0,05). Außerdem hatten HoLEP-Patienten im Vergleich zu TURP-Patienten eine kürzere Enukleationsdauer, ein höheres Gewicht der enukleierten Prostata, eine geringere Hämoglobinverminderung, eine kürzere Blasenspülungszeit, eine kürzere Katheterverweildauer und einen kürzeren Krankenhausaufenthalt (P<0,05). Obwohl es vor der Operation keinen Unterschied in IPSS, Qmax und Lebensqualität zwischen den beiden Gruppen gab (P>0,05), war der Unterschied 6 Monate nach der Operation statistisch signifikant (P<0,05).

Schlussfolgerung Die HoLEP ist bei BPH-Patienten sicher und wirksam und der transurethralen TURP bei älteren Patienten überlegen.

Keywords

BPH - HoLEP - TURP

Schlüsselwörter

Prostatahyperplasie - Transurethraler Holmium Laser Enukleation der Prostata - Transurethrale Prostatektomie

Publikationsverlauf

Eingereicht: 08. September 2023

Angenommen nach Revision: 02. November 2023

Artikel online veröffentlicht:
23. Januar 2024

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