Initial safety and efficacy of holmium laser enucleation of the prostate: real world evidence from a tertiary centre.

Abstract

Objective: This study aims to evaluate the initial safety and efficacy of Holmium enucleation of the prostate (HoLEP) in managing benign prostatic hypertrophy (BPH) in a single tertiary centre.

Materials & methods: A retrospective cohort study was conducted focusing on a single tertiary hospital in which data was collected from electronic medical records which includes demographic information, preoperative characteristics, surgical details, and post-operative outcomes; complications were classified using the Clavien-Dindo classification.

Results: 104 patients with BPH and lower urinary tract symptoms (LUTS) were analysed in this study, with a mean prostate volume of 109.3 ± 47.2 ml. The mean change in post void residual volume (PVR) was (-)75%, whilst the mean change in maximum flow rate (QMax) was (+)109%. 21/104 (19%) patients presented with post-operative complications, the majority of these (13) were Grade I complications with three patients being Grade III. Increasing age (p = 0.014) was shown to have contributed to complications. Pre-operative anticoagulation was shown to yield no significance (p = 0.066).

Conclusion: HoLEP remains a viable treatment modality for BPH especially in larger prostates (> 100 ml). However, considerations regarding post-operative outcomes should be taken when offering this treatment to more elderly patients. Additionally, HoLEP provides a good treatment option for patients on anticoagulation.