Comparative Analysis of the Effectiveness of Modern Endoscopic Methods of Treatment of BPH

ABSTRACT: Lower urinary tract symptoms caused by benign prostatic hyperplasia are the most common urological problem among men, affecting about a third of men over the age of 50

Of all surgical treatments, monopolar transurethral resection of the prostate (TURP), in which enlarged prostate tissue is resected piece by piece using a monopolar electrode, has been the standard method since the 1970s. It can significantly improve maximum flow rate (Qmax), urination-related symptoms (based on the International Prostate Symptom Assessment Scale (IPSS)), and health-related quality of life with long-term efficacy compared to medications or other minimally invasive treatments [4].

Since the 2000s, new energy systems for surgery for benign prostatic hyperplasia have rapidly become popular, including systems using bipolar energy and various laser systems such as holmium laser, potassium titanyl phosphate (KTP) laser, thulium laser and diode laser Over the past 10 years, the trend in the surgical treatment of benign prostatic hyperplasia has shifted from monopolar TURP to laser therapy and bipolar TURP. Based on the data on the effectiveness of the HoLEP technique, it becomes clear that HoLEP is ready to replace all these methods as a new standard, based on almost two decades of data that consistently demonstrate its better results and lower complication rate. This review summarizes the available literature by comparing HoLEP and traditional BPH treatments that are widely used and have long-term efficacy data.

Despite the fact that there is such a wide arsenal of surgical treatment of BPH, each of these methods has its own advantages and disadvantages. This review article contains a significant portion of the best randomized data directly comparing HoLEP with alternative surgical treatments.