Objective:

To compare the perioperative outcomes and short-term efficacy of holmium laser enucleation of the prostate (HoLEP) vs. transurethral resection of the prostate (TURP) in patients with symptomatic benign prostatic hyperplasia (BPH).

Approach:

• Study Design: A non-randomized retrospective, observational, single-center cohort study analyzing data from 176 patients who underwent surgical treatment for BPH.
• Patient Groups: Patients were divided into two groups: HoLEP (n = 92) and TURP (n = 84).
• Data Analysis: Baseline characteristics, operative parameters, postoperative complications, and functional outcomes were compared between the groups.

Key Findings:

• HoLEP had a significantly shorter operation time (58.26 ± 20.11 min vs. 84.17 ± 36.80 min, P < 0.001).
• HoLEP resulted in shorter catheterization time (5.37 ± 1.45 vs. 6.27 ± 1.47 days, P < 0.001) and reduced hospital stay (7.33 ± 3.12 vs. 13.61 ± 4.14 days, P < 0.001).
• HoLEP showed better functional outcomes with improved international prostate symptom score and higher Qmax (all P < 0.05).
• Lower rates of urinary tract irritation (22.62% vs. 42.86%) and erectile dysfunction (16.67% vs. 29.76%) were observed in the HoLEP group (both P < 0.05).

Interpretation:

HoLEP is a safe and effective alternative to TURP for BPH, offering advantages in perioperative safety and early recovery.

Limitations:

• The study was retrospective and non-randomized, which may introduce selection bias.
• No propensity score matching or multivariate confounding adjustment was applied.

Conclusion:

HoLEP may be particularly beneficial in patients with large prostates or higher bleeding risk.