Laparoscopic adenomectomy versus Eraser laser enucleation of the prostate

• Published in: World journal of urology Vol. 33; no. 5; pp. 691 - 696
• Main Authors: Lusuardi, L., Hruby, S., Janetschek, G., Mitterberger, M., Sieberer, M., Colleselli, D., Kunit, T., Hitzl, W., Kloss, B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2015; Springer Nature B.V
• Subjects: Aged; Blood Loss, Surgical; Follow-Up Studies; Humans; Laparoscopy - methods; Laser Therapy - methods; Length of Stay; Lower Urinary Tract Symptoms - etiology; Lower Urinary Tract Symptoms - prevention & control; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Operative Time; Original Article; Prostate - pathology; Prostate - surgery; Prostatectomy - methods; Prostatic Hyperplasia - complications; Prostatic Hyperplasia - pathology; Prostatic Hyperplasia - surgery; Treatment Outcome; Urinary Bladder Neck Obstruction - etiology; Urinary Bladder Neck Obstruction - prevention & control; Urology; Benign prostatic hyperplasia; Laparoscopic adenomectomy; Bladder neck surgery; Laser surgery; Prostate
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-014-1476-1

Purpose To evaluate functional outcomes and morbidity rates after laparoscopic adenomectomy (LA) and Eraser laser enucleation of the prostate (ELEP). Materials and methods Forty patients with lower urinary tract symptoms suggesting bladder outlet obstruction, with a prostate heavier than 70 g on transrectal ultrasound, were selected to undergo laparoscopic adenomectomy or Eraser laser enucleation of the prostate. All patients were consecutively enrolled without randomization and assessed preoperatively, 3 and 6 months postoperatively. Baseline characteristics, perioperative data, and postoperative outcomes were compared. Results The total operating time was significantly longer in the LA group (138.8 ± 11.4 vs. 78.4 ± 10.0 min, p  < 0.000001). Catheter removal was performed earlier (61.2 ± 21.3 vs. 174.0 ± 13.2 h, p  < 0.000001) and the hospital stay was significantly shorter (62.4 ± 21.2 vs. 187.2 ± 12.6 h, p  < 0.000001) in the ELEP group. The latter group experienced significantly less perioperative hemoglobin (Hb) loss (0.71 ± 0.25 vs. 2.15 ± 1.08 g/dl, p  < 0.000001), and their postoperative Hb levels (14.1 ± 1.21 vs. 11.7 ± 1.31 g/dl, p  < 0.000001) were significantly higher. The resected tissue was significantly greater in the LA group (58.5 ± 23.3 vs. 87.9 ± 22.4 g, p  = 0.0002). Significant improvements in Qmax, Qol, and symptom scores from baseline to each follow-up time point were noted in both groups. No statistically significant difference in symptom scores or Qmax was registered between the LA and the ELEP group throughout the follow-up period. Conclusion Laparoscopic adenomectomy and ELEP were equally effective for relieving bladder outflow obstruction and lower urinary tract symptoms. The advantages of ELEP include less blood loss, shorter catheterization times, and shorter hospital stays.