Holmium laser enucleation of prostate for patients with acute urinary retention due to benign prostate hyperplasia: Efficacy and safety

2019 ◽  
Author(s):  
Pu Li(Former Corresponding Author) ◽  
Jun Tao ◽  
Chengming Wang ◽  
Min Tang ◽  
Xiaoxin Meng(New Corresponding Author)

Abstract Background Benign prostate hyperplasia (BPH) is a common disease in older men, and part of patients develop acute urinary retention (AUR) at the time of initial treatment. The aim of this study was to evaluate the effectiveness and safety of holmium laser enucleation of prostate (HoLEP) for patients with BPH in setting of AUR. Methods The clinical data of 88 patients with BPH who underwent HoLEP surgery in our center were retrospectively analyzed. AUR existed in 34 patients and the other 54 patients had no AUR. The general information, prostate volume, urodynamic parameters and intraoperative parameters were recoeded and compared. The outcome were recorded and analysed including the international prostate symptom score (IPSS), quality of life score (QoL), maximum urinary flow rate (Qmax), and post-voiding residual (PVR). Results In both groups, the preoperative parameters were equivalent except for the white blood cell in urinalysis. All the HoLEP procedures were smoothly carried out. The intr- and post-operative complications were low in both groups and no difference were detected. All the patients were followed up for at least 6 months. IPSS, QoL, Qmax and PVR were all improved in both groups. No statistical differences were obtained in these parameters between groups. Conclusion s HoLEP could be a safe and effective treatment for BPH patients either with or without AUR. The efficacy was immediate and sustained during the short-term follow-up session in both groups.

2019 ◽  
Vol 13 (6) ◽  
pp. 155798831989448
Author(s):  
Jie Sun ◽  
Zhen Tong ◽  
An Shi ◽  
Dong Li ◽  
Wei Xue ◽  
...  

Holmium laser enucleation of the prostate (HoLEP) is one of the minimally invasive procedures that is used for patients with benign prostate hyperplasia. The procedure usually requires patients to stay in the hospital 2 nights or longer. The present study evaluated the safety and feasibility of HoLEP with discharge of the patients on Day 1 after surgery (1-day surgery). A total of 1,164 patients were included in the study, with 510 of them planned for 1-day surgery and others planned for inpatient surgery. The primary outcomes included complication rate and clinical outcomes. A total 489 out of 510 patients received 1-day HoLEP and were discharged on Day 1 after surgery. In a 30-day follow-up period, no significant differences were found between the 1-day and inpatient surgery groups in terms of the rate of complications and clinical outcomes. Patients in the 1-day surgery group had a significantly shorter waiting time for admission (9.5 ± 4.8 vs. 17.6 ± 7.4 days, p < .05), and the mean hospitalization cost was lower (CNY$ 9140.6 ± 1452.2 vs. 10533.4 ± 1594, p < .05).The 1-day HoLEP surgery was safe and had satisfactory clinical outcomes. This treatment strategy could reduce the waiting time for admission and cost of hospitalization. Majority of the patients found this 1-day surgery beneficial, especially elderly patients who prefer to have an early return home and rapid resumption of activities.


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