This study aims to compare efficacy and safety between photoselective vaporization of the prostate (PVP) with Green- Light laser and Holmium laser enucleation of the prostate (HoLEP).
A total of 220 patients who underwent endoscopic disobstruction surgery of the prostate were included; Of which, 110 had PVP and 110 had HoLEP (prospective cohort). Preoperative, intraoperative and postoperative variables were recorded, including hospital stay, catheterisation duration, adverse effects, transfusion rate, maximum urinary flow (Qmax) at 12 months, reduction of prostate-specific antigen (PSA) at 6 months, urgency, urinary continence and urethral stricture. Statistical analysis was performed with Fisher's exact, Student's t and Mann-Whitney U tests, with a significance level of p < 0.05.
Both groups presented comparable preoperative characteristics. No significant differences were observed in the days of admission, days of catheterisation, adverse effects, transfusion rate or readmission rate. However, the HoLEP group showed a significantly higher Qmax (31.31 mL/s vs. 24.48 mL/s, p = 0.014) and a greater reduction in PSA (94.54% vs. 47.11%, p = 0.008). Urgency was lower in the HoLEP group (0.9% vs. 11.8%, p = 0.001), and the rate of urinary continence was identical in both groups (99.09%). Urethral stricture was higher in the HoLEP group (4.5% vs. 0.9%, p = 0.219), although the difference was not statistically significant (p > 0.05).
Overall, PVP and HoLEP present a low morbidity rate and present similar long-term urinary continence rates. Moreover, HoLEP offers a greater improvement in urinary flow and a greater reduction in PSA but leads to a higher rate of urethral stricture than PVP.
Archivos espanoles de urologia. 2026 Apr [Epub]
Eduardo García Rico, Luis Enrique Ortega Polledo, Alejandro Sánchez Pellejero, Geo Bianchini Hernández, Juan Gómez Rivas, Angeles Sanchis Bonet, Isabel Galante Romo, Jesús Moreno Sierra, Sergio Alonso Y Gregorio
Peña-Hidalgo-Alonso Institute of Urology, 28004 Madrid, Spain., Department of Urology, Clinico San Carlos Hospital, 28040 Madrid, Spain.