Comparison of Diode Laser (980nm) Enucleation versus Holmium Laser Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia: A Randomized Controlled Trial with 12-Month Follow-up.

To compare the clinical efficacy and safety between diode laser (980nm) enucleation of the prostate (DiLEP) and holmium laser enucleation of the prostate (HoLEP) for treating benign prostatic hyperplasia (BPH).

126 BPH patients in our hospital from December 2016 to December 2017 were enrolled in this study. They were randomized to DiLEP group or HoLEP group, which were administrated with DiLEP and HoLEP treatment respectively. The patient's characteristics, such as age, body mass index (BMI), co-morbidities, prostate volume, prostate-specific antigen (PSA), were recorded before surgery. The perioperative outcomes and complications were also compared. The maximum flow rate (Qmax), postvoid residual (PVR), international prostate symptom score (IPSS), quality of life (QoL) score were assessed at baseline and 3, 6, 12 months postoperatively.

No significant differences were observed for the patient's baseline characteristics between both groups. For the perioperative outcomes, including operative time, resected tissue weight, catheter duration and hospital stay, no significant difference was found between two groups. However, the DiLEP group showed less blood loss and decrease in hemoglobin compared to HoLEP group. The incidence of early or late complications was similar for both groups. The Qmax, PVR, IPSS, and QoL for both groups of patients were dramatically improved after surgery. By comparing the Qmax, PVR, IPSS, and QoL between the two groups, no significant differences were detected in 3-month, 6-month, or 12-month follow-up.

This study demonstrated that both DiLEP and HoLEP are efficient and safe treatments for BPH patients. DiLEP showed less blood loss and decrease in hemoglobin than HoLEP, which indicated that diode laser (980nm) generate better hemostasis effect.

Journal of endourology. 2019 Jul 12 [Epub ahead of print]

Gaofei He, Yuanyuan Shu, Bohan Wang, Chuanjun Du, Jimin Chen, Jiaming Wen

The Second Affiliated Hospital, School of Medicine, Zhejiang University, Department of Urology, Hangzhou, Zhejiang, China ; ., The Second Affiliated Hospital, School of Medicine, Zhejiang University, Department of Urology, Hangzhou, Zhejiang, China ; ., The Second Affiliated Hospital, School of Medicine, Zhejiang University, Department of Urology, Hangzhou, Zhejiang, China ; ., The Second Affiliated Hospital, School of Medicine, Zhejiang University, Department of Urology, Hangzhou, Zhejiang, China ; ., The Second Affiliated Hospital, School of Medicine, Zhejiang University, Department of Urology, Hangzhou, Zhejiang, China ; ., The Second Affiliated Hospital, School of Medicine, Zhejiang University, Department of Urology, Hangzhou, Zhejiang, China ; .