Related Experiment Video
Updated: Jun 23, 2026
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).
Published on: March 6, 2018
Novel 30-amp MOSES versus MOSES 2.0 pulse-modulation technologies for holmium laser enucleation of the prostate
Hazem Elmansy1, Ahmed Mousa2,3, Amr Hodhod4
1Houston Methodist Hospital, Houston, TX, USA. hazem.mansy@rocketmail.com.
Purpose:
We aimed to compare early perioperative and functional outcomes of holmium laser enucleation of the prostate (HoLEP) performed with the 30-amp MOSES system and MOSES 2.0 technology.
Methods:
We retrospectively compared 65 patients who underwent HoLEP with the 30-amp MOSES system and 210 with MOSES 2.0 between June 2023 and April 2025.Intraoperative and perioperative outcomes were collected and analyzed at 1, 3, and 6 months postoperatively.
Results:
The two groups had comparable preoperative characteristics, with median prostate volumes of 105 and 111 cc in the MOSES 2.0 and 30-amp MOSES groups, respectively (p = 0.22). Intraoperatively, the MOSES 2.0 group demonstrated an 8-minute shorter median enucleation time (p = 0.007), a 3-minute shorter median hemostasis time (p < 0.001), and lower energy use (75.7 vs. 92.1 kJ, p < 0.001). Additionally, MOSES 2.0 demonstrated superior enucleation efficiency compared to 30-amp MOSES (2.2 vs. 2 g/min, p = 0.047). Other operative parameters were comparable between the two groups. Both technologies achieved comparable successful same-day trial of void rates of 94% in the MOSES 2.0 group and 93.4% in the 30-amp MOSES group (p = 0.88). Postoperative functional outcomes, including IPSS, QoL, Qmax, PVR, and PSA, were comparable between groups up to 6 months of follow-up.
Conclusion:
HoLEP with 30-amp MOSES technology is a safe and effective option for treating benign prostatic obstruction. Both MOSES systems support same-day discharge with comparable safety and functional outcomes. The 30-amp MOSES system may offer a practical alternative for institutions without a dedicated 50-amp power supply. Large randomized controlled trials with longer follow-up are warranted.
Insights
Holmium laser enucleation of the prostate (HoLEP) using MOSES 2.0 technology showed improved efficiency and reduced operative times compared to the 30-amp MOSES system. Both methods offer safe and effective treatment for benign prostatic obstruction with similar functional outcomes.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Laser Technology
Background:
- Benign prostatic obstruction (BPO) is a common condition affecting aging men.
- Holmium laser enucleation of the prostate (HoLEP) is an effective surgical treatment for BPO.
- Advancements in laser technology aim to improve HoLEP efficiency and patient outcomes.
Purpose of the Study:
- To compare early perioperative and functional outcomes of HoLEP using the 30-amp MOSES system versus MOSES 2.0 technology.
- To evaluate the safety and efficacy of both HoLEP systems in treating BPO.
- To assess the potential of the 30-amp MOSES system as an alternative for facilities with limited power supply.
Main Methods:
- Retrospective comparison of 65 patients treated with the 30-amp MOSES system and 210 patients treated with MOSES 2.0.
- Data collection included intraoperative, perioperative, and functional outcomes up to 6 months postoperatively.
- Statistical analysis was performed to compare outcomes between the two groups.
Main Results:
- MOSES 2.0 demonstrated significantly shorter enucleation and hemostasis times, and lower energy consumption.
- Enucleation efficiency was superior with MOSES 2.0 (2.2 g/min vs. 2 g/min).
- Both systems achieved comparable same-day trial of void rates (94% vs. 93.4%) and similar functional outcomes (IPSS, QoL, Qmax, PVR, PSA) up to 6 months.
Conclusions:
- HoLEP with both 30-amp MOSES and MOSES 2.0 is safe and effective for BPO treatment.
- Both systems facilitate same-day discharge with comparable safety and functional results.
- The 30-amp MOSES system presents a viable option for centers lacking a 50-amp power supply; further randomized trials are recommended.
