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No. 036. Holmium laser enucleation of the prostate verses laparoscopic simple prostatectomy for the treatment of large BPH. R. Thanigasalam , R. Juaneda , A.El Hajj, W.Massoud , P-E. Thevenaud , M. Fennouri , F.Girard , O.Dumonceau & H.Baumert

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No. 036

Holmium laser enucleation of the prostate verses laparoscopic simple prostatectomy for the treatment of large BPH

R. Thanigasalam, R. Juaneda, A.El Hajj, W.Massoud, P-E. Thevenaud, M. Fennouri, F.Girard, O.Dumonceau & H.Baumert

Department of Urology, GroupeHospitalier Paris Saint-Joseph, Paris 75014, France

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  • Results

  • In the HoLEP group, 4 patients (20%) experienced complications according to the modified Clavien classification system. Three were grade I and one IIIb. In the laparoscopic group, 5 patients suffered complications (25%). Four of them were grade I and one grade II.

  • No patient in either group required a blood transfusion.


Holmium Laser Enucleation of the Prostate (HoLEP) has been proposed as a possible new “Gold Standard” for the treatment of bladder outlet obstruction due to large prostatic adenomas.

It has proven similar efficacy to other techniques for the treatment of benign prostatic hyperplasia (BPH), however there are no studies comparing HoLEP with laparoscopic simple prostatectomy (LSP).


In this study we compared HoLEP with LSP in patients with large glands (>100grams) requiring surgical intervention.

  • Methods

  • Prospectively collected data was analysed retrospectively, comparing the outcomes of 20 trans-vesicalLSPs with 20 HoLEPs, performed by a single experienced surgeon (HB).

  • Patients in the two groups were pair-matched according to prostate volume from the trans-rectal ultrasound.

  • Study variables included operative and catheterization time, hospital stay, International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax) and complication rates.


HoLEP has similar functional results and complication rates when compared with LSP in large glands, with the advantage of providing a shorter catheterization time and reduced hospital stay.