Operating-room-based surgeries other than transurethral resection for benign prostatic hyperplasia
| Treatment | Photoselective vaporization of prostate | Holmium laser enucleation of the prostate | Simple prostatectomy | Robotically controlled water jet treatment |
|---|---|---|---|---|
| Surgery type | Cystoscopic laser vaporization | Cystoscopic laser excision | Abdominal excision | Cystoscopic water jet ablation |
| Operative setting | Operating room | Operating room | Operating room | Operating room |
| Anesthesia | General or spinal | General or spinal | General or spinal | General 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 |
| Contraindications | Prior radiation | (Not available) | Anticoagulation Elevated bleeding risk | Anticoagulation Elevated bleeding risk |
| Advantages | Excellent hemostasis Small caliber scope | Size-independent Durable results | Done under vision (robotic) Durable results | Preserves sexual function |
| Postoperative catheter time | 1 day | 1 day | 5–10 days | 1–5 days |
| Durability | Good | Excellent | Excellent | Unknown |
| Erectile dysfunction | Rare | Uncommon | Uncommon | None |
| Unique complications | Obstruction from sloughed tissue passage | Bladder injury from morcellator | Risks of surgical incision Risks of intra-abdominal surgery | Unknown |