Introduction: The MOSES pulse laser system has been shown to improve hemostasis and operative time during Holmium laser enucleation of the prostate (HoLEP) compared to the standard holmium laser enucleation. In a previous prospective double blinded randomized controlled trial, short term functional outcomes and complications were equivalent between the two groups. We sought to report extended outcomes from the same patient cohort.
Methods: In this study, we retrospectively investigated long term outcomes of patients who underwent HoLEP with either MOSES technology or the standard holmium laser from a previous single-center, prospective, double-blind randomized controlled trial. Postoperative complications after the 6-week postoperative period, as well as prostate specific antigen levels (PSA), International Prostate Symptom scores (IPSS), Quality of Life (QoL), International Index of Erectile Function 5-item (IIEF-5) and voiding efficiency (VE) were reviewed.
Results: 60 patients from the previous trial were included. Median/mean postoperative follow-up was 33.5 weeks (IQR 43). At extended follow-up, there continues to be no difference between the MOSES and standard group in PSA, IPSS, QoL, IIEF-5, VE, and complications after the initial 6-week postoperative period (p> 0.05, Table 1). There were only 2 patients with complications after the 6-week postoperative period. One patient within the standard group required cystoscopy and evacuation of prostatic calcifications causing recurrent gross hematuria 56 weeks postoperatively. Another patient with a history of Myasthenia Gravis within the MOSES group had urinary incontinence postoperatively. There were no reported incidences of bladder neck contracture or urethral strictures in either group.
Conclusions: Use of MOSES technology during HoLEP has shown to improve operative time and reduction of blood loss when compared to the standard holmium laser fiber. These results show that MOSES technology has comparable safety and functional outcomes that are sustained at extended follow-up.
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