Transurethral green laser enucleation of prostate versus transurethral vaporization of prostate in treatment of severe benign prostatic hyperplasia

Objective To compare the efficacy of transurethral green laser enucleation of the prostate (GLEP) and transurethral vaporization of prostate (TUVP) in the treatment of patients with severe benign prostatic hyperplasia (BPH).

Methods A total of 214 patients with severe BPH were selected and randomly divided into GLEP group and TUVP group, with 107 cases in each group. The perioperative indexes as well as the maximum urinary flow rate (Q_max), residual urine volume (RUV), serum total prostate specific antigen (tPSA), score of the International Prostate Symptom Scale (IPSS), the score of Quality of Life for BPH patients (BPH-QOL) and score of the International Erectile Function Questionnaire-5 (ILEF-5) before and after the surgery were compared between two groups.

Results The intraoperative bleeding amount, operation time, postoperative flushing time for bladder, indwelling time of the catheter and hospital stay in the GLEP group were (56.85±10.21) mL, (75.83±9.12) min, (25.12±5.03) h, (1.91±0.62)d and (3.52±0.83) d, respectively, which were significantly less or shorter than (60.43±11.05) mL, (91.49±12.95) min, (40.21±9.78) h, (2.76±0.74)d and (4.45±1.17)d in the TUVP group (P < 0.05). At 6 months after operation, Q_max and BPH-QOL score in both groups were significantly higher than those before operation, while RUV, serum tPSA level, ILEF-5 score and IPSS score were significantly lower than those before operation (P < 0.05); at 6 months after operation, Q_max was (23.35±4.41) mL/s in the GLEP group, which was significantly higher than (20.03±3.95) mL/s in the TUVP group, and ILEF-5 score was (10.29±2.85) in the GLEP group, which was significantly higher than (8.38±2.16) in the TUVP group (P < 0.05). The total incidence rate of complications in the GLEP group was 5.61%, which was significantly lower than 22.43% in the TUVP group (P < 0.05).

Conclusion GLEP and TUVP have the similar short-term efficacy in the treatment of patients with severe BPH, but GLEP has less intraoperative bleeding amount, faster postoperative recovery, fewer complications and less influence on sexual function.