Surgical Stress Response in Holmium Laser Enucleation of the Prostate versus Transurethral Resection of the Prostate: a Prospective Non-Randomized Study

Aim: To compare immunoinflammatory markers and the surgical stress response in patients undergoing conventional transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HoLEP). Materials and Methods:Patients with the diagnosis of benign prostate hyperplasia who needed surgical treatment were enrolled in either TURP or HoLEP surgery.Two consecutive cohorts of 25 patients in each group were non-randomly recruited based on prostate volume.Interleukin-6, C-reactive protein, tumor necrosis factor alpha, white blood cell count, neutrophilto-lymphocyte ratio, CD4+/CD8+ ratio, and adrenaline and cortisol levels were determined at three different times: before the operation, immediately afterward, and on postoperative day 1.Operation durations, lengths of inhospital stays, and postoperative pain scores were also assessed.Results: The mean age was 63.1 ± 6.7 years.Interleukin-6 and C-reactive protein values were statistically higher in both groups at postoperative day 1 than preoperatively (p < 0.05).Interleukin-6 and C-reactive protein levels were significantly higher in the TURP at postoperative day 1 than HoLEP (p < 0.05).The operation duration in the TURP group was significantly shorter than in the HoLEP.The length of hospital stay was shorter in the HoLEP (p < 0.05).There was less postoperative pain in the HoLEP (p < 0.05). Conclusion:This study shows that surgical stress response is attenuated in patients undergoing HoLEP surgery in comparison with patients receiving TURP surgery.