Introduction

Endoscopic enucleation of the prostate (EEP) is considered as a less invasive treatment than open simple prostatectomy (OP) for prostate adenoma >80 ml. Nevertheless, the learning curve of EEP is still challenging. Our objective was to assess perioperative outcomes and functional results between EEP (GreenLEP and HoLEP) within the learning curve and OP done by experimented surgeons.

Methods

We prospectively enrolled the first 30 cases of GreenLEP and the first 32 cases of HoLEP which have been grouped together (EEP group) and retrospectively compared them with the 46 consecutives OP performed by seasoned senior surgeons (OP group). Greenlight® enucleation was performed with the &[laquo]en bloc&[raquo] technic (GreenLEP) using the HPS® fibre, HoLEP was performed with three lobes technic using the Lumenis® laser 100W Holmium. We collected patient&[prime]s characteristics, perioperative outcomes, functional results and complications after a 6-months follow-up. Comparisons between groups were performed using χ2 test and Fisher exact test for discrete variables and Mann-Whitney test for continuous variables.

Results

Patients characteristics were similar except for prostate volume (OP: 139 ±6.2g, EEP: 102 ±7,5; P<0.001). Operative time was longer in the EEP group (108 ±4min vs 76 ±5min; P<0.001). Time before catheter removal was shorter in the EEP group (P<0.001) and hospital length of stay which was higher in the OP group (9.5 ±0.4 days vs 4.3 ±0.3 days , P<0.001). Complications rate was lower in the EEP: 24% (n=15) vs 46% (n=21); P=0.02 (Table 1). Decrease of prostate volume, IPSS and quality of life score were similar between both groups. Postoperative stress urinary incontinence was comparable between groups at 1 month (40% vs 26.8%, p=0.15) and 3 months (22.4% vs 12.5%, P= 0.19) of follow-up._x000D_

Conclusions

Whatever the laser technic (Greenlight or holmium), we suggest that endoscopic enucleation remains less morbid and provides similar functional outcomes than OP even in the learning curve._x000D_

Funding

none