Pulse modulation in En-Bloc HoLEP: does it really matter? A propensity score matched analysis.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Laser Technology

Background:

• Holmium laser enucleation of the prostate (HoLEP) is a standard surgical treatment for benign prostatic hyperplasia.
• Pulse modulation technology, such as MOSES®, is a recent advancement in HoLEP that may offer benefits.

Purpose of the Study:

• To compare the perioperative outcomes of MOSES® laser enucleation of the prostate (MoLEP) with traditional HoLEP.
• To evaluate the safety and efficiency of MoLEP in patients with benign prostatic hyperplasia.

Main Methods:

• Perioperative data from 117 MoLEP patients were collected.
• Propensity score matching with 237 HoLEP patients was performed based on prostate volume, age, BMI, and anticoagulant use.
• A total of 234 patients were included in the final analysis.

Main Results:

• No significant differences were observed between MoLEP and HoLEP groups in terms of prostate volume, age, BMI, or anticoagulant intake.
• Operation time, enucleation efficiency, hemostasis time, and hemoglobin drop were comparable between the two groups.
• Both procedures demonstrated low complication rates, with no significant differences in Clavien-Dindo Classification or Comprehensive Complication Index.

Conclusions:

• HoLEP and MoLEP exhibit high enucleation efficiency and short procedure times.
• HoLEP remains an efficient and safe treatment for benign prostatic hyperplasia in experienced hands, irrespective of pulse modulation technology.