***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The study compared the transurethral resection in saline ( TURis ) , transurethral vaporization in saline ( TUVis ) , bipolar plasma enucleation of the prostate ( BPEP ) , and open prostatectomy ( OP ) in a single-center , prospect i ve , r and omized controlled clinical setting exclusively involving large prostate patients . PATIENTS AND METHODS During a 4½ year enrollment period , 320 cases of prostate volume over 80 mL , maximum flow rate ( Qmax ) below 10 mL/second , International Prostate Symptom Score ( IPSS ) over 19 , or urinary retention were included in the trial and equally r and omized in the four study arms . Patients were assessed preoperatively as well as at the 1- , 3- , 6- , and 12-month follow-up checkups using the IPSS , quality of life ( QoL ) score , Qmax , postvoiding residual urinary volume ( PVR ) , and prostate-specific antigen ( PSA ) . RESULTS Similar preoperative parameters were established in the four series . OP and BPEP were characterized by resembling operating times , while TURis and TUVis displayed prolonged surgical duration s. TURis emphasized a substantially decreased mean resected tissue weight . TUVis showed the lowest mean hemoglobin level drop , followed by TURis and BPEP ( equivalent results ) and finally OP ( highest bleeding ) . OP described the longest mean catheterization period and hospital stay , followed by TURis , and afterward by TUVis and BPEP ( similar data ) . During the follow-up period , statistically equivalent IPSS , QoL , Qmax , and PVR outcomes were established for OP , BPEP , and TURis . TUVis displayed significantly smaller Qmax improvements , but similar other functional features . Significantly lower mean PSA levels were determined secondary to OP and BPEP when compared to bipolar resection and subsequently to vaporization . CONCLUSIONS OP and BPEP emphasized the highest surgical efficiency ( prolonged postoperative recovery for OP ) , while TUVis displayed the lowest hemorrhagic risks . On the medium term , generally resembling functional outcomes were determined for the four techniques , with significantly decreased mean PSA values secondary to OP and BPEP PURPOSE Prostate adenomas greater than 100 gm . have traditionally been treated with open prostatectomy . This procedure may involve considerable blood loss , morbidity , prolonged hospital stay and recovery time . The high powered holmium : YAG laser can be used endoscopically to enucleate obstructing prostatic tissue in a relatively bloodless manner . The technique of transurethral holmium laser enucleation of the prostate is compared to open prostatectomy for the surgical management of large prostate adenomas in a prospect i ve r and omized study . MATERIAL S AND METHODS A total of 120 urodynamically obstructed patients with a prostate larger than 100 gm . on transrectal ultrasound were r and omized to undergo holmium laser enucleation of the prostate or open prostatectomy . All patients were assessed preoperatively and 1 , 3 and 6 months postoperatively . Patient baseline characteristics , perioperative data and postoperative outcome were compared . All complications were noted . RESULTS Holmium laser enucleation of the prostate and open prostatectomy result ed in a similar and significant improvement in American Urological Association symptom scores , peak urinary flow rates and post-void residual urine volumes . Operating time was significantly longer in the holmium group but blood loss was significantly less , and catheterization time and hospital stay were significantly shorter . Effects on continence and potency were similar in both groups but adverse events were less frequent in the holmium group . None of the holmium group patients needed blood transfusions in contrast to 8 patients in the prostatectomy group . CONCLUSIONS Holmium laser enucleation of the prostate and open prostatectomy are equally effective procedures for removal of large prostatic adenomas . Holmium laser enucleation result ed in significantly less perioperative morbidity and may become the endourological alternative to open prostatectomy OBJECTIVES To compare the effectiveness and the safety of photoselective vaporization of the prostate ( PVP ) to open prostatectomy ( OP ) for the surgical treatment of large prostatic adenomas . METHODS A total of 125 patients with prostate gl and s > 80ml were r and omly allocated to PVP ( n=65 ) or OP ( n=60 ) and prospect ively evaluated at 1 , 3 , 6 , and 12 mo postoperatively . International Prostate Symptom Score ( IPSS ) and peak urinary flow rate ( Q(max ) ) were chosen as primary treatment-related end points . RESULTS The patients who underwent PVP experienced a longer length of operation time , shorter time of catheterization , and shorter hospital stay . Adverse events were minor and of similar profiles in both groups , although patients who underwent OP showed a higher transfusion rate . All functional parameters improved significantly compared to baseline values in both groups . The IPSS did not differ between the two groups at 3 , 6 , and 12 mo postoperatively . Patients who underwent OP scored better in the IPSS quality of life score at 6 and 12 mo postoperatively . No significant differences between the two groups in the Q(max ) , postvoid residual urine volume , and International Index for Erectile Function-5 question naire were detected . At 3 mo prostate volume was significantly lower in the OP group compared to the PVP group ( median value 10ml vs. 50ml ; p<0.001 ) and remained as such throughout follow-up , whereas prostate-specific antigen values reached statistical difference at 6 mo ( median value 2ng/ml vs. 2.4ng/ml ; p=0.028 ) . CONCLUSIONS Our results indicate that for a 12-mo period PVP is a highly acceptable treatment alternative to OP CONFLICT OF INTEREST None Take Home Message : This is a prospect i ve r and omized study showing that for large prostatic adenomas , photoselective vaporization of the prostate requires less blood transfusions , shorter catheterization time and shorter hospital stay compared to open prostatectomy , while achieving similar functional results at the same time . AIM The effectiveness and the safety of photoselective vaporization of the prostate ( PVP ) was compared to that of open prostatectomy ( OP ) for the surgical treatment of large prostatic adenomas . METHODS 125 patients with prostate gl and s>80 ml , were r and omly allocated to PVP ( n=65 ) or OP ( n=60 ) and prospect ively evaluated at 1 , 3 , 6 , 12 , and 18 months postoperatively . International prostate symptom score ( IPSS ) and peak urinary flow rate ( Qmax ) were chosen as primary treatment-related endpoints . RESULTS Longer length of operation time , shorter length of catheterization and hospital stay were experienced by patients who underwent PVP . Although patients who underwent OP showed a higher transfusion rate , adverse events in general were minor and of similar profile in both groups . All functional parameters improved significantly compared to baseline values in both groups . There was no difference in IPSS between the two groups at 3 , 6 , 12 , and 18 months postoperatively . Patients who underwent OP scored better in the IPSS- Quality of life score at 18 months postoperatively . At 18 months there were no significant differences between the two groups in the Qmax , post void residual urine volume and in the International Index for Erectile function-5 question naire . At three months prostate volume was significantly lower in the OP group and remained as such throughout follow-up . CONCLUSIONS Our results indicate that for an 18 month period photoselective vaporization of the prostate is a highly acceptable treatment alternative to open prostatectomy Objectives : To determine the feasibility of holmium laser enucleation of the prostate ( HoLEP ) combined with mechanical morcellation to surgically treat bladder outflow obstruction due to the larger prostate . Methods : The first 14 patients treated with this new combination technique are described . St and ard preoperative investigations were performed and all patients were assessed at 1 month postoperatively with an AUA symptom score and peak urinary flow rate ( Qmax ) . Both transurethral ( 8 patients ) and suprapubic ( 6 patients ) morcellation was utilised . Results : The mean ultrasound volume of the prostate was 98.6 ml ( 55–200 ) . The mean total operating room time was 98 min ( 64–190 ) . No patient required blood transfusion but 2 patients required postoperative bladder irrigation . Twelve of the patients were discharged catheter-free the following day . The only significant complication was extraperitoneal extravasation from the suprapubic site in 2 patients . At 1 month the mean Qmax was 25.2 ml/s and the mean AUA score was 7.2 . Conclusions : This combination of techniques offers a minimally morbid method of treating the larger prostate gl and OBJECTIVE To prospect ively evaluate perioperative results and 12-month follow-up after plasmakinetic enucleation of the prostate ( PKEP ) and transvesical open prostatectomy ( OP ) for benign prostatic hyperplasia ( BPH ) > 80 mL. METHODS A total of 83 patients with a prostate > 80 mL were r and omized to either  PKEP or OP . Perioperative and postoperative outcome data were obtained during a 12-month follow-up . RESULTS No statistical differences were observed in the preoperative data . Both groups result ed in a similar and significant postoperative improvement in International Prostate Symptom Score ( IPSS ) , quality of life ( QOL ) , maximum uroflow rate ( Qmax ) , postvoid residual ( PVR ) urine volume and prostate specific antigen ( PSA ) , but no significant difference was found between the groups at the 12-month follow-up . Compared to OP , operation time ( 111.2 ± 27.1 minutes vs 109.6 ± 28.2 minutes , P = .708 ) were not significantly different between the groups , but blood loss was significantly less ( 10.2 ± 4.5 g/l vs 15.1 ± 4.3 g/l , P < .001 ) , and bladder irrigation ( 2.4 ± 1.0 days vs 4.3 ± 1.1 days , P < .001 ) , catheterization time ( 3.3 ± 1.1 days vs 6.2 ± 1.3 days , P < .001 ) , and hospital stay ( 5.4 ± 1.2 days vs 9.3 ± 1.1 days , P < .001 ) were significantly shorter in the PKEP group . Effects on erectile function were similar in both groups , but adverse events were less frequent in the PKEP group . CONCLUSION PKEP can be performed safely and is an equally effective procedure for treatment of large BPH with OP , with minimal complications and faster postoperative recovery . The PKEP helps to reduce the morbidity associated with OP and may become the attractive alternative to OP for patients with large BPH PURPOSE We prospect ively analyzed the complications and immediate postoperative outcome of  open prostatectomy for benign prostatic hyperplasia to provide reference data for emerging techniques , such as holmium laser enucleation of the prostate and laparoscopic prostatectomy . MATERIAL S AND METHODS A total of 902 patients with a mean + /- 1 SD age of 71.3 + /- 6.8 years were evaluated while undergoing open prostatectomy in Bavaria , Germany from January 1 , 2002 to December 31 , 2003 . We prospect ively analyzed 54 parameters concerning preoperative status , surgical details , complications and immediate outcome . RESULTS Mean operative time was 80.8 + /- 34.2 minutes . Mean prostate size was 96.3 + /- 37.4 ml . Average enucleated tissue was 84.8 + /- 44.0 gm . Incidental carcinoma of the prostate  was found in 28 of 902 patients ( 3.1 % ) and the mortality rate was 0.2 % . The overall complication rate was 17.3 % . The most relevant complications were bleeding requiring transfusion in 68 cases ( 7.5 % ) , urinary tract infection in 46 ( 5.1 % ) and surgical revision due to severe bleeding in 33 ( 3.7 % ) . Patients had an average International Prostate Symptom Score of 20.7 + /- 7.6 preoperatively . Mean urinary peak flow rate increased significantly to 23.1 + /- 10.5 ml per second from a baseline of 10.6 + /- 6.4 ml per second ( p < 0.0001 ) . Post-void residual volume decreased to 17.5 + /- 34.8 ml from a baseline of 145.1 + /- 152.8 ml ( p < 0.0001 ) . CONCLUSIONS Open prostatectomy showed a satisfactory early postoperative outcome with a complication rate that was within the expected range compared to that in the recent literature . It represents an important option in the treatment of patients with significant benign enlargement of the prostate for surgeons with no access to modern techniques , such as holmium laser enucleation of the prostate or laparoscopy BACKGROUND AND PURPOSE Treatment of the large ( > 100 g ) prostatic adenoma often involves open prostatectomy , with its attendant risks and morbidity . Enucleation of the entire adenoma endoscopically is possible with the holmium : YAG laser and tissue removal from within the bladder by a transurethral 
    Output:
    
There was significantly less blood transfusion with TUEP , but no significant differences were found in other complications such as recatheterization , urinary tract infection , reintervention for clots and bleeding control , incidence of pneumonia and infa rct ion , transient incontinence , bladder neck contracture , urethral stricture and recurrent adenoma .
Conclusions TUEP can be performed effectively and safely with functional outcomes and complications similar to OP for large BPH , whereas it has the advantages of a shorter catheter period , shorter hospital stays and less blood transfusion .