Long-term Outcomes of HoLEP vs. GreenLight PVP: Which Prostate Treatment Lasts Longer?

What is it about?

This research compares the long-term functional outcomes and reoperation rates of holmium laser enucleation of the prostate (HoLEP) and GreenLight photoselective vaporisation of the prostate (GLPVP) for treating benign prostatic hyperplasia. It includes randomised controlled trials, cohort studies, and case series with at least a 5-year follow-up, sourced from MEDLINE, Embase, and Cochrane databases. The analysis found that HoLEP offers greater long-term durability and lower reoperation rates (mean 4.1%) than the 80-W/120-W GLPVP models, which have a higher reoperation rate (mean 12.6%). The 180-W GLPVP model showed comparable outcomes to HoLEP at 5 years, though data beyond 10 years is lacking. This study highlights the need for more long-term data and comparative studies, as well as noting issues like patient attrition affecting the findings. Overall, HoLEP demonstrated superior functional improvements and sustained benefits in objective measures like Qmax and PVR compared to GLPVP.

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Why is it important?

This review examines the long-term functional outcomes and reoperation rates of holmium laser enucleation of the prostate (HoLEP) compared to GreenLight photoselective vaporisation of the prostate (GLPVP) in the treatment of benign prostatic hyperplasia (BPH). The significance lies in its synthesis of data from multiple studies, offering insights into the durability and efficacy of these laser treatments, which are increasingly considered alternatives to traditional surgical methods. Understanding these outcomes can guide clinical decision-making and patient management strategies for BPH. Key Takeaways: 1. This review summarises that HoLEP demonstrates greater long-term durability in functional outcomes and lower reoperation rates compared to the older 80-W/120-W models of GLPVP over a mean follow-up of 7.3 years. 2. The analysis indicates that while GLPVP shows durable outcomes at 5-year follow-up, evidence for its efficacy diminishes at 10 years, with higher reoperation rates compared to HoLEP. 3. The review highlights that the newer 180-W GLPVP model may offer improved durability at 5 years, but there is insufficient data on its long-term outcomes beyond this period.