Related Experiment Video
Updated: May 10, 2025
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
Published on: March 6, 2018
Comparison of outcome for holmium laser enucleation prostate and Rezum system in benign prostate hyperplasia: a
Orkunt Özkaptan1, Cüneyd Sevinç2, Cengiz Çanakcı3
1Department of Urology, Health Sciencies University, Kartal Dr. Lutfi Kirdar City Hospital, D100 Güney Yanyol Cevizli, Kartal, Istanbul, 34890, Turkey.
Purpose:
Our aim was to assess the efficacy and safety of Rezum therapy in patients with symptomatic benign prostatic hyperplasia (BPH) in comparison to Holmium laser enucleation of the prostate (HoLEP).
Methods:
The retrospective study included 338 patients (204 HoLEP and 134 Rezum) operated on for BPH between January 2020 and November 2024. A 1:1 matching of treated patients (Rezum) to HoLEP patients based on the closest propensity score value was conducted for 131 successful matching pairs. The groups were compared regarding; Age, Prostate volume, PSA, Catheter-dependence, Qmax, PVR, IIEF, IPSS, PGI-I, operation time (OT) and hospital time (HS).
Results:
Concerning perioperative data, there was a statistically significant difference between the Rezum and HoLEP groups regarding OT (8.29 ± 1.21 vs. 68.01 ± 31.01 min; P < 0.001) and HS (1 vs. 2.61 ± 1.53 days; P < 0.001) with higher values for HoLEP. At the same time, the catheter duration was longer in the Rezum group (7.6 ± 2.19 vs. 3.49 ± 1.16 days; P < 0.001). In terms of clinical outcomes, there was a statistically significant improvement in Qmax, IPSS and a decrease in PVR at 12 months for the HoLEP group compared to the Rezum group (16.82 ± 2.27 ml/sn vs. 22.14 ± 7.17 ml/sn, P < 0.001; 12.1 ± 2.1 vs. 7.1 ± 1.9, P < 0.001; 43.05 ± 32.62 ml vs. 29.73 ± 43.73 ml, P = 0.006; respectively). PGI-I scores (p = 0.620) and antegrade ejaculation (p < 0.001) were in favour of Rezum therapy.
Conclusion:
The HoLEP technique demonstrates superior functional outcomes compared to Rezum, particularly in cases with larger prostates. However, Rezum is an ejaculation-sparing technique demonstrating high tolerability, and patient satisfaction even in larger prostates.
