[Operative therapy of benign prostatic hyperplasia: enucleation procedures (HoLEP and ThuVEP)]

Area of Science:

• Urology
• Minimally Invasive Surgery

Context:

• Benign prostatic obstruction (BPO) is a common condition.
• Open simple prostatectomy is a traditional treatment.
• Laser enucleation offers a minimally invasive alternative, particularly for large prostates.

Purpose:

• To compare holmium:YAG laser enucleation of the prostate (HoLEP) and thulium:YAG laser vapoenucleation of the prostate (ThuVEP) for BPO.
• To evaluate the efficacy and safety of laser enucleation techniques.

Summary:

• HoLEP and ThuVEP are established transurethral laser procedures for BPO.
• Both techniques utilize similar wavelengths and surgical approaches but differ in energy delivery (pulsed vs. continuous wave).
• Both HoLEP and ThuVEP significantly improve urinary symptoms, quality of life, flow rate, and reduce post-void residual urine, with notably lower bleeding complications compared to open surgery.

Impact:

• Laser enucleation provides effective BPO treatment with reduced morbidity.
• HoLEP demonstrates long-term durability up to 10 years.
• ThuVEP shows promising results with an 18-month follow-up, reflecting its more recent clinical implementation.