HoLEP与TURP治疗良性前列腺增生的围手术期及远期疗效比较

Objective To compare the clinical outcomes of holmium laser enucleation of the prostate(HoLEP) and transurethral resection of the prostate(TURP) for the treatment of benign prostatic hyperplasia(BPH). Methods The clinical data of 130 patients were retrospectively analyzed, including 68 patients who underwent HoLEP and 62 who underwent TURP. Perioperative parameters, functional outcomes at 12 months postoperatively, and complications were compared between the two groups. Multivariable regression and subgroup analyses stratified by prostate volume were also performed. Results The operative time was longer in the HoLEP group than in the TURP group. However, intraoperative blood loss, reduction in hemoglobin level, duration of bladder irrigation, catheterization time, and length of hospital stay were all lower or shorter in the HoLEP group(P<0.001). At 12 months postoperatively, the International Prostate Symptom Score(IPSS), quality-of-life(QoL) score, and postvoid residual urine volume(PVR) were lower, whereas the maximum urinary flow rate(Qmax), 5-item International Index of Erectile Function(IIEF-5) score, and IPSS improvement rate were higher in the HoLEP group than in the TURP group(P<0.05). The overall complication rate was also lower in the HoLEP group(11.76% vs. 22.58%, P=0.041). After adjustment for relevant variables, HoLEP was associated with a greater likelihood of IPSS improvement(OR=2.87, 95% CI: 1.32～6.18). Conclusion Although HoLEP requires a longer operative time than TURP, it is associated with less bleeding, faster postoperative recovery, and better functional outcomes at 12 months. Its potential advantages in patients with larger prostate volumes require further investigation.