Novel 30-amp MOSES versus MOSES 2.0 pulse-modulation technologies for holmium laser enucleation of the prostate (HoLEP)

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Elmansy H.; Mousa A.; Hodhod A.; Abdul Hadi R.; Nour H.; Alharbi M.; Berjaoui M.B.; Tayebi S.-L.; Morgan M.; Gonzalez R.R.; Zakaria A.S.

Journal: World Journal of Urology

Publisher: Springer Science and Business Media Deutschland GmbH

Publication Date: 22 June 2026

Volume / Issue: Volume 44 / Issue 1

Article No.: 449

ISSN: 7244983

DOI: 10.1007/s00345-026-06530-x

Scopus: View on Scopus

PubMed: 42329295

Document Type: Article

Authors and Affiliations

Elmansy H., Houston Methodist Hospital, Houston, TX, United States; Mousa A., Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Thunder Bay, ON, Canada, Theodor Bilharz Research Institute, Giza, Egypt; Hodhod A., King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia; Abdul Hadi R., Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Thunder Bay, ON, Canada; Nour H., Theodor Bilharz Research Institute, Giza, Egypt; Alharbi M., Qassim University, Qassim, Buraydah, Saudi Arabia; Berjaoui M.B., University of Toronto, Toronto, ON, Canada; Tayebi S.-L., Western University, London, ON, Canada; Morgan M., Houston Methodist Hospital, Houston, TX, United States; Gonzalez R.R., Houston Methodist Hospital, Houston, TX, United States; Zakaria A.S., Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Thunder Bay, ON, Canada

Abstract

Purpose: 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. Methods: We 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. Results: The 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. Conclusion: HoLEP 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. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026.

Keywords

Benign prostatic hyperplasia; Laser prostate surgery; MOSES technology; Prostate; Aged; Humans; Laser Therapy; Lasers, Solid-State; Male; Middle Aged; Prostatectomy; Prostatic Hyperplasia; Retrospective Studies; Treatment Outcome; comparative study; devices; drug therapy; human; procedures; prostate hypertrophy; retrospective study; solid state laser; surgery

Citation Information

Scopus Citations: 0

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