Introduction

With the demographic shift in industrial societies, more patients present with Bladder Outlet Obstruction (BOO) due to locally advanced prostate cancer. As no guideline recommendations exist for techniques, the intraoperative performance, postoperative outcomes, and safety of palliative (p)TURP and (p)HoLEP were evaluated.

Materials and Methods

A retrospective, propensity score-matched analysis of 1,373 and 2,705 men who underwent TURP or HoLEP for LUTS/BOO was conducted. Patients were categorized by technique and compared for perioperative parameters, safety, and short-term functional outcomes.

Results

Postoperative symptoms and urodynamic parameters improved regardless of technique. Despite longer resection and enucleation times for palliative cases, HoLEP’s benefits remained superior to TURP. Surgical performance (g/min) was twice as high for both techniques in prostate cancer patients.

Conclusion

While both laser enucleation and TURP are safe and effective, pHoLEP offers better surgical performance. This study fills a key gap in literature, aiding urological surgeons in making evidence-based decisions for patient care.

European Association of Urology, 21-24 March 2025, Madrid, Spain