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Updated: Jun 26, 2025
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Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
Published on: March 6, 2018
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Aquablation versus HoLEP in patients with benign prostatic hyperplasia: a comparative prospective non-randomized
Jakob Michaelis1, Max Träger1, Sophie Astheimer1
1Department of Urology, Faculty of Medicine, Medical Centre - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
World Journal of Urology
|May 9, 2024
Summary
Holmium laser enucleation of the prostate (HoLEP) demonstrated superior safety and volumetric outcomes compared to aquablation for benign prostate hyperplasia (BPH). Aquablation offered temporary benefits in ejaculation and continence, but HoLEP showed better long-term results.
Area of Science:
- Urology
- Surgical Innovation
- Men's Health
Background:
- Lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) significantly impact quality of life.
- Surgical interventions are common, but the optimal treatment remains debated.
- Aquablation and HoLEP are advanced surgical options for BPH.
Purpose of the Study:
- To compare the clinical outcomes of aquablation and holmium laser enucleation of the prostate (HoLEP) in patients with BPH.
- To evaluate functional results, safety, and perioperative characteristics of both procedures.
Main Methods:
- A prospective cohort study comparing aquablation and HoLEP for BPH.
- Patients underwent procedures based on preference between June 2020 and April 2022.
- Comprehensive pre- and post-operative evaluations included uroflowmetry, symptom scores (IPSS, ICIQ-SF, MSHQ-EjD, EES, IIEF), and Clavien Dindo (CD) complications.
Main Results:
- Both aquablation and HoLEP significantly improved IPSS scores without significant differences at 12 months.
- HoLEP had a shorter operative time and superior prostate volume reduction.
- Aquablation showed temporary advantages in ejaculatory and continence function at 3 months.
- HoLEP demonstrated a better safety profile with fewer severe complications (CD ≥ grade 3b).
Conclusions:
- HoLEP offers superior outcomes in terms of operative time, safety, and volumetric reduction for BPH treatment.
- Aquablation provides transient benefits for ejaculatory and continence function.
- HoLEP appears to be a more robust surgical option for managing BPH based on this cohort's data.
