Novel 30-amp MOSES versus MOSES 2.0 pulse-modulation technologies for holmium laser enucleation of the prostate (HoLEP)
摘要
We aimed to compare early perioperative and functional outcomes of holmium laser enucleation of the prostate (HoLEP) performed with the 30-amp MOSES system and MOSES 2.0 technology.
MethodsWe retrospectively compared 65 patients who underwent HoLEP with the 30-amp MOSES system and 210 with MOSES 2.0 between June 2023 and April 2025.Intraoperative and perioperative outcomes were collected and analyzed at 1, 3, and 6 months postoperatively.
ResultsThe two groups had comparable preoperative characteristics, with median prostate volumes of 105 and 111 cc in the MOSES 2.0 and 30-amp MOSES groups, respectively (p = 0.22). Intraoperatively, the MOSES 2.0 group demonstrated an 8-minute shorter median enucleation time (p = 0.007), a 3-minute shorter median hemostasis time (p < 0.001), and lower energy use (75.7 vs. 92.1 kJ, p < 0.001). Additionally, MOSES 2.0 demonstrated superior enucleation efficiency compared to 30-amp MOSES (2.2 vs. 2 g/min, p = 0.047). Other operative parameters were comparable between the two groups. Both technologies achieved comparable successful same-day trial of void rates of 94% in the MOSES 2.0 group and 93.4% in the 30-amp MOSES group (p = 0.88). Postoperative functional outcomes, including IPSS, QoL, Qmax, PVR, and PSA, were comparable between groups up to 6 months of follow-up.
ConclusionHoLEP with 30-amp MOSES technology is a safe and effective option for treating benign prostatic obstruction. Both MOSES systems support same-day discharge with comparable safety and functional outcomes. The 30-amp MOSES system may offer a practical alternative for institutions without a dedicated 50-amp power supply. Large randomized controlled trials with longer follow-up are warranted.