Eighteen Years of Holmium Laser Enucleation of the Prostate: A Single Center Experience
Meta-analyses and randomized trials have confirmed how well established holmium laser enucleation of the prostate (HoLEP) for treatment of benign prostatic hyperplasia (BPH). HoLEP showed superior efficacy compared to the traditional transurethral resection of the prostate. The aim of the present study was to report our experience with long-term outcomes of HoLEP over a period of 18 years.
between March 1998 and March 2016, a prospectively collected database for patients undergoing HoLEP for symptomatic BPH performed by a single surgeon was reviewed. Demographic and perioperative data were collected together with the International Prostate Symptoms Score (IPSS), Quality of Life (QoL), peak flow rate (Qmax), residual urine (PVR), and prostate specific antigen (PSA) changes. In addition, perioperative and late adverse events were recorded.
Demographic and perioperative data are presented in table 1. After a mean follow-up of 11.2 years (2-18 years), 1455 patients were included with a mean age of 68.9 ( 53- 86) years. The mean catheter time and hospital stay were 1.2 and 1.3 days, respectively. Intraoperatively, no patient needed blood transfusion. Urethral stricture and bladder neck contracure were encountered in 21 (1.4%) and 30(2.1%) patients, respectively while 21 (1.4%) patinets needed redo HoLEP for regrowth of obstructing adenoma (Table 1). Regarding the long-term functional outcomes, there were significant differences between baseline and post-operative values of PSA, IPSS, QoL, Qmax, and PVR (p<0.001) (Table 2). </p>
Holmium laser enucleation of the prostate is safe, effective and durable for benign prostatic hyperplasia over long-term follow-up.