HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HoLEP) VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) IN THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA (BPH): A SYSTEMATIC REVIEW OF THE EVIDENCE

Abstract

This study aimed to compare the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) with transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia (BPH). This is a systematic review conducted according to the PRISMA 2020 statement, with searches in the PubMed, SciELO and LILACS databases for studies published in Portuguese, English and Spanish. Study selection was performed on the Rayyan platform, and risk of bias was assessed with the RoB 2 and ROBINS-I tools. Eight studies were included, of which four randomized clinical trials, totaling 549 patients, directly compared the two techniques. HoLEP showed less perioperative bleeding, shorter bladder catheterization time and shorter hospital stay. Improvement in the International Prostate Symptom Score (IPSS) was similar between techniques, with higher maximum urinary flow rate (Qmax) after HoLEP in some studies. On the other hand, operative time was longer with HoLEP. HoLEP is an effective and safe alternative to TURP, with advantages in postoperative outcomes, although the heterogeneity and limited number of studies require an individualized choice of technique.