METHODS
Study design and patient evaluation:
After receiving the local ethics committee approval, between October 2019 and July 2020, in this prospective and comparative trial, a total of 120 consecutive patients with BPH induced LUTS refractory to medical treatment or developing complications secondary to prostatic obstruction were included and divided into two groups based on the power of the device used namely Group 1 (50 watt) and group 2 (100 watt) groups. The patients were assigned respective numbers according to the hospital admission time, and these numbers were then classified as odd numbers in group 1 and even numbers in group 2. Exclusion criteria were neurological disorder (e.g.Parkinson’s disease, cerebral ischemic event), active urinary infection, active hematuria, prostate cancer and previous urethral or prostatic surgery. Following medical history and digital rectal examination, urine culture, serum prostate specific antigen (PSA, ng/ml), suprapubic ultrasound-determined prostate volume (ml), American Society of Anesthesiologists (ASA) scores, International Prostate Symptom Scores (IPSS), maximum flow rates (Q max), postvoiding residual volumes (PVR), and Quality of Life (QoL) index values were all assessed and recorded prior to the procedure. Transrectal prostate biopsy was performed if indicated and biopsy negative patients were operated at least 4 weeks later. Patients receiving coumadin stopped the medication 5 days before HoLEP and were bridged with low molecular weight heparins during the perioperative period. New oral anticoagulants (such as dabigatran, rivaroxaban, apixaban, and edoxaban) were discontinued 48-72 h before surgery. Patients receiving acetylsalicylic acid and platelet aggregation inhibitors (such as clopidogrel, ticagrelor, and prasugrel) were operated under acetylsalicylic acid treatment.Antithrombotic treatment was resumed as soon as bleeding control was achieved. All preoperative baseline characteristics were recorded.