1470 nm diode laser enucleation versus bipolar transurethral resection of the prostate for the surgical management of benign prostatic hyperplasia: a randomized comparison.

The purpose of this study is to compare the safety and efficacy of 1470 nm diode laser enucleation of the prostate (DiLEP) with modified bipolar transurethral resection of the prostate (B-TURP) in the surgical management of benign prostatic hyperplasia (BPH). 81 patients presenting with symptomatic BPH were randomly assigned to undergo either DiLEP (n = 41) or B-TURP (n = 40). Baseline properties, perioperative characteristics, complication data, and 12-month follow-up outcomes between both groups were comparatively analyzed. As a result, no significant differences were observed in basic properties between two groups. The 1470 nm DiLEP demonstrated comparable efficacy to B-TURP in improving maximum flow rate (Qmax), International Prostate Symptom Score (IPSS), post-void residual urine (PVR), and quality of life (QoL) score. However, compared to B-TURP, 1470 nm DiLEP exhibited superior retrieval efficiency (0.7 g/min vs. 0.5 g/min, P = 0.001), reduced blood loss (9.4 g/L vs. 13.7 g/L, P = 0.011), shorter operative duration (69.8 min vs. 96.2 min, P = 0.015), as well as decreased postoperative irrigation (17.8 h vs. 32.5 h, P = 0.003) and catheterization time (3.9 days vs. 6.0 days, P < 0.001). Surgical complications were somewhat less common in the DiLEP group than in the B-TURP group. Overall, one-year follow-up outcomes demonstrated that 1470 nm DiLEP exhibited comparable safety and efficacy in alleviating lower urinary tract symptoms (LUTS) and benign prostatic obstruction (BPO) to B-TURP. However, it showed superior surgical efficiency and enhanced hemostatic control in the resection of medium to large prostates compared to B-TURP.