I guess the steep learning curve of HoLEP may play a role especially that PVP looks easier to proceed with. Furthermore, the enucleation lines are more difficult to keep and follow than PVP.

Another factor may be related to the relatively longer opertive time with HoLEP due to large glands, where the chance to complete a full procedure by the residents is much lower than PVP where they could manage the whole procedure. Therefore, they would be more comfortable with PVP.

The learning of greenligh laser prostatectomy is much easier than HoLEP

The primary difference between PVP and HoLEP is that PVP involves prostate tissue ablation through vaporization as opposed to enucleation. There has been a rapid and widespread acceptance of PVP worldwide, primarily due to its efficacy, safety and patient acceptance. Training recommendations are yet to be established, however, and training is considered an area for improvement.

Because you don't have me in your department to show you how to do a HoLEP.

As a urologist with an almost 50 years of experience I feel that I can be frank.

PVP is like TURP. You do not have to remove/evaporate the entire adenoma but most of the patients will be still happy for a few years to be unobstructed.

HoLEP is the equivalent of open prostatectomy (adenomectomy) where  almost always you enucleate the entire large adenoma if you know how to do it.

In the past we forst learned to do an open prostatectome and then the TURP.

Now it is vice-versa: the residents first learn to do PVP and then when they feel comfortable they start to learn doing HoLEP

Because you spend time to enucleate and to morcelate the adenomatous tissue at the end of HoLEP.

I  completely agree with the thought of  Daniel Yachia.The difference is that open adenomectomy is easier to learn  then HoLEP and TURP more difficult then PVP

For a resident who is familiar with TURP, PVP looks easier than Holep. Furtehrmore, to master Holep you should have a good mentor, to see some procedures before starting to perform under supervision. You need 30 procedures to master well the technique

Our surgeon Griffith Richard Batstone has been doing the HOLEP and recovery is quicker, less painful, and with less leakage = happier patients. He has "fine-tuned" the HOLEP to decrease the leakage even further!

I agree with Griffith Richatd Batsone.

 The best results are obtained with  old open adenomectomy and HOLEP is the modern less invasive version of open adenomectomy.The problems are,to day,  longer learning curve and not so many  good   teachers of this new  technique. I think that future is HOLEP.

Daniel Yachia is correct. Holep needs a morcellement after laser. Atomic photoablation needs no more catheter a.s.o.in PVP.. Only problem is the price for special fibres though physics show us that by work with resterilized 0.6 mm reusable bare fibres  procceding can be performed with 2$/per operation. Not everywhere - or better said in states where >one wayproducts< must be used in PVP You can get problems Your Hainz