Operating-room-based surgeries other than transurethral resection for benign prostatic hyperplasia

TreatmentPhotoselective vaporization of prostateHolmium laser enucleation of the prostateSimple prostatectomyRobotically controlled water jet treatment
Surgery typeCystoscopic laser vaporizationCystoscopic laser excisionAbdominal excisionCystoscopic water jet ablation
Operative settingOperating roomOperating roomOperating roomOperating room
AnesthesiaGeneral or spinalGeneral or spinalGeneral or spinalGeneral or spinal
Ideal prostate size≤ 100 cc (sometimes a bit larger)≤ 250 cc> 80 cc, with or without concomitant pathology, eg, bladder calculi, diverticula≤ 150 cc
ContraindicationsPrior radiation(Not available)Anticoagulation
Elevated bleeding risk
Elevated bleeding risk
AdvantagesExcellent hemostasis
Small caliber scope
Durable results
Done under vision (robotic)
Durable results
Preserves sexual function
Postoperative catheter time1 day1 day5–10 days1–5 days
Erectile dysfunctionRareUncommonUncommonNone
Unique complicationsObstruction from sloughed tissue passageBladder injury from morcellatorRisks of surgical incision
Risks of intra-abdominal surgery