Endoscopic en bloc prostate enucleation: a propensity score matched analysis between greenlight enucleation of prostate (GreenLEP) vs holmium laser enucleation of prostate (HOLEP) outcomes and safety with a 12-month follow-up

Purpose Greenlight has been successfully used to treat BPH since 2010s; however, its role during GreenLEP is still under investigation, differently from holmium in HOLEP. Study aim is to compare GreenLEP and HOLEP. Methods Data for GreenLEP and HOLEP were prospectively collected in two referral cent...

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Vydané v:International urology and nephrology Ročník 57; číslo 12; s. 3957 - 3967
Hlavní autori: Morselli, Simone, De Rienzo, Gaetano, Ditonno, Pasquale, Ferrari, Sergio, Lucarelli, Giuseppe, Spilotros, Marco, Zaraca, Carlo, Greco, Piergiorgio, Rabito, Salvatore, Micali, Salvatore, Ferrari, Riccardo, Toso, Stefano, Gatti, Lorenzo, Ferrari, Giovanni, Cindolo, Luca
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Dordrecht Springer Netherlands 01.12.2025
Springer Nature B.V
Predmet:
Aged
Antibiotics
Anticoagulants
Bladder
Cancer therapies
Catheters
Clinical trials
Disease prevention
Endoscopy
Endoscopy - methods
Enucleation
Follow-Up Studies
Hemoglobin
Humans
Laser Therapy - methods
Lasers
Lasers, Solid-State - therapeutic use
Male
Medicine
Medicine & Public Health
Middle Aged
Multivariate analysis
Nephrology
Patients
Propensity Score
Prospective Studies
Prostate
Prostate cancer
Prostatectomy - adverse effects
Prostatectomy - methods
Prostatic Hyperplasia - surgery
Surgery
Time Factors
Treatment Outcome
Urology
Urology – Original Paper
United States > US
BPO
Greenlep
Holep
BPH
Prostate enucleation
Laser
ISSN:1573-2584, 0301-1623, 1573-2584
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Shrnutí:Purpose Greenlight has been successfully used to treat BPH since 2010s; however, its role during GreenLEP is still under investigation, differently from holmium in HOLEP. Study aim is to compare GreenLEP and HOLEP. Methods Data for GreenLEP and HOLEP were prospectively collected in two referral centers since 2021. Outcomes and safety were compared through propensity score matching. All patients had at least 12-month follow-up. Results A total of 120 patient who underwent GreenLEP and 115 HOLEP were enrolled. At unmatched comparison, median PSA and age were comparable, as well as prostate volume, with a median of 98.5 (IQR 82.0–130.0)ml and 90.0 (IQR 65.0–115.0)ml, respectively; on the contrary, IPSS ( p  = 0.013) and indwelling catheter rate ( p  =  < 0.001) were higher in HOLEP group. Moreover, safety and functional outcomes were comparable, besides lower PSA and IPSS were found at 12-month follow-up in HOLEP group ( p  < 0.001). Using propensity score matching on 56 GreenLEP and 56 HOLEP, the groups were comparable for age, prostate volume, PSA, ongoing anticoagulant and anti-aggregant therapy, ongoing BPH therapy, pre-operative hemoglobin values, indwelling catheter presence, and IPSS. Regarding outcomes, they were all comparable except lower IPSS and PSA at 6- and 12-month follow-up for HOLEP. Conversely, late complications and stress incontinence were higher in HOLEP (1.8% vs 16.1%, p  = 0.008), but at multivariate analysis, there was no significant difference. Conclusion According to our results, both HOLEP and GreenLEP are effective in treating BPH in large prostates. However, HOLEP provided slightly better IPSS and PSA reduction, while GreenLEP demonstrated fewer late complications. Further randomized clinical trials are mandatory.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1573-2584
0301-1623
1573-2584
DOI:10.1007/s11255-025-04543-w