Holmium Laser Resection of the Prostate Versus Neodymium:Yttrium-Aluminum-Garnet Visual Laser Ablation of the Prostate: A Randomized Prospective Comparison of Two Techniques for Laser Prostatectomy

Objectives. To directly compare holmium laser resection of the prostate (HoLRP) with neodymium:yttrium-aluminum-garnet visual laser ablation of the prostate (VLAP), which represent two fundamentally different methods of laser prostatectomy. Methods. In a randomized, prospective comparison, a total of 44 men with symptomatic benign prostatic hyperplasia (BPH) were treated with either HoLRP or VLAP. Standard preoperative assessment included American Urological Association (AUA) symptom score, peak urinary flow rates (Qmax), ultrasound prostate volume, and residual urine measurements. Pressure-flow urodynamics were performed preoperatively and at 3 months postoperatively. Intraoperative and perioperative factors were assessed. The patients were followed at 1, 3, 6, and 12 months following the procedure. Results. There were no significant differences between the patient groups for any preoperative parameter. The mean total operating time was longer in the HoLRP group (52 minutes) compared with the VLAP group (41 minutes) ( P