A randomised trial published in this month's British Journal of Urology International looked at the outcomes for patients with larger prostates (80 to 150cc) undergoing either greenlight laser prostate vaporisation (PVP), bipolar TURP (TURIS) or holmium enucleation of the prostate (HoLEP).
This well conducted randomised trial of 182 pateints by Elshal et al. found that patients undergoing HoLEP or PVP recovered faster with fewer complications compared with bipolar TURP (TURIS).
After 3 years of follow up HoLEP has the best long term results with none of the 60 patients who had a HoLEP requiring further surgery, compared with 6.7% in the PVP group and 9.7% in the TURIS groups.
This supports other published studies that show endoscopic enculeation techniques (such as HoLEP) are the new gold standard in providing durable results for men with enlarged prostates.