To report our initial experience with enhanced MOSES 2.0 technology in patients who underwent holmium laser enucleation of the prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH), in comparison to those who underwent HoLEP with MOSES 1. 0 technology at our institution.
We retrospectively reviewed data of patients who underwent HoLEP using MOSES 1.0 or MOSES 2.0 pulse-modulation technology from December 2020 to September 2023. Preoperative and intraoperative parameters, postoperative outcomes, as well as perioperative complications were collected and analyzed.
A total of 196 patients were included in the study. Among them, 146 patients underwent MOSES 1.0 HoLEP, while 50 had MOSES 2.0 HoLEP. No statistically significant differences in preoperative characteristics were observed between the two groups. The median prostate volume for the MOSES 1.0 and MOSES 2.0 HoLEP groups was 109 cc and 117.5 cc, respectively. Patients in the MOSES 2.0 group had a shorter median enucleation time (52.5 vs. 42.5 min, p < 0.001) and hemostasis time (8 vs. 6 min, p = 0.002), along with lower laser energy usage (101 vs. 86.4 kJ, p = 0.012), when compared to those in the MOSES 1.0 cohort. Postoperative outcomes, including IPSS, QoL, Qmax, and PVR, were comparable between the two groups at 1, 3, and 6 months postoperative. The incidence of hospital readmission (p = 0.42), as well as one-month postoperative urge urinary incontinence (p = 0.2) and stress urinary incontinence (p = 0.13) were also comparable between the cohorts.
HoLEP with second-generation MOSES 2.0 technology is a safe and effective treatment option for BPH. It offers notable improvements, including reduced enucleation and hemostasis times, while using less energy when compared to MOSES 1.0.
World journal of urology. 2024 Oct 16*** epublish ***
Hazem Elmansy, Ryan Boudreau, Amr Hodhod, Saud Alhelal, Husain Alaradi, Khaled Alotaibi, Ruba Abdul Hadi, Oksana Blahitko, Ryan Kelly, Ahmed S Zakaria
Urology Department, Northern Ontario School of Medicine, Thunder Bay Regional Health Sciences Centre, 146 Court Street South Thunder Bay, Thunder Bay, ON, P7B 2X6, Canada. ., Urology Department, Northern Ontario School of Medicine, Thunder Bay Regional Health Sciences Centre, 146 Court Street South Thunder Bay, Thunder Bay, ON, P7B 2X6, Canada., Urology Department, King Abdulaziz Medical City, National Guard Hospitals Affairs, Riyadh, Saudi Arabia.