الفهرس 
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Abstract
Patients with LUTS due to BPH who were meeting the study inclusion criteria (transrectal ultrasound estimated prostate volume from 40 to 150 ml) were randomized between HOLEP (50 patients) and PVP (53 patients). Perioperative variables were reported and compared. Patients were followed at 1, 4 and 12 months postoperative. All functional subjective (symptoms score and quality of life score) and objective outcome parameters (flow rate, residual urine and changes in prostate volume and PSA) were assessed and compared. The primary endpoint was the symptom score at one year. Non-inferiority of PVP using XPS in symptom score reduction was tested against HOLEP. The mean IPSS at 12 months was comparable (4.3 vs. 5.3, P= 0.41) in HOLEP and PVP groups respectively. Significantly higher mean postoperative flow rate at 12 months (31.1 vs. 18.5 ml/sec, P= 0.01), ultrasound estimated prostate volume reduction (74.3% vs. 43.1%, P=0.00) and postoperative 12 months PSA reduction (82.6% and 45.9%, P= 0.01) in HOLEP vs. PVP respectively. Auxiliary use of TUR loop was needed at the conclusion of two HOLEP procedures for hemostasis and in 21 (39.5%) PVP procedures for hemostasis and removal of residual prostatic tissue. Reoperation within the first year was needed in 2 (4%) cases after HOLEP, one for stone encrustations in the prostatic fossa and the second was for bladder neck contracture. After PVP, 3 cases (5.6%) were brought back to the operating room, 2 for residual prostatic adenoma and one for stone encrustations in the prostatic fossa. The mean estimated cost per HOLEP procedure was significantly lower than per PVP procedure. The higher cost of PVP procedure was mainly due to the cost of single use laser fibre and a slight difference in hospital admission time. In conclusion: Greenlight PVP using the XPS-MOXY fibers was shown to be safe and effective modality in treating LUTS secondary to BPH and was not inferior to HOLEP at one year.
Reoperations after PVP remain a concern. Efforts should be done to augment the visual indicators for the endpoint of vaporization. Eventually, the cost issue of Greenlight PVP XPS-MOXY is a critical concern when compared to HOLEP. Further follow up is needed to ensure long-term durability of the outcome.