Introduction: We aimed to compare the outcomes of three different benign prostatic hyperplasia (BPH) procedures in the management of BPH patients with overactive bladder (OAB) symptoms.

Methods: Between March 2012 and December 2020, A total of 170 BPH patients who had preoperative OAB symptoms and underwent transurethral resection of the prostate (TURP), holmium laser enucleation of the prostate (HoLEP), or photoselective vaporization of the prostate (PVP) were retrospectively reviewed. Patients were included only if they had detrusor overactivity and postvoid residual <150 ml. Patients’ characteristics, preoperative urodynamics study (UDS) parameters, preoperative and postoperative OAB symptomatology, International Prostate Symptom Score (IPSS), procedure complications, and postoperative need for treatment were collected, analyzed, and compared.

Results: A total of 170 BPH patients with OAB symptoms were divided into three groups based on their BPH intervention: TURP (89 patients), HoLEP (64 patients), and PVP (17 patients). Urgency (p=0.031) and urge incontinence (p=0.004) were significantly improved in the HoLEP and PVP groups compared to the TURP group at three months postoperative. At three and six months, there were significant improvements of all OAB symptoms in comparison to preoperative parameters (Table 1).

Conclusions: TURP, HoLEP, and PVP are effective and reliable surgical procedures that can be used for BPH patients with OAB symptoms. Compared to TURP, HoLEP and PVP provide better improvement in urgency and urge incontinence.