Laser enucleation of the prostate: Overview of our results after the first 18 months of acquisition

Abstract

Introduction: New techniques using laser are now available as an alternative to conventional techniques in the treatment of benign prostatic hyperplasia (BPH). Holmium laser enucleation of the prostate (HoLEP) reproduces via endoscopy have shown results similar to that of open prostatectomy. Objective: To give an overview of the use of HoLEP in Robert Boulin hospital (Libourne, FRANCE) and to study its feasibility even in a center that has no prior experience in this technique. Patients and methods: This is a retrospective descriptive study from November 2013 to April 2015 of all patients who underwent HoLEP by two urologists with no prior experience of this technique. Results: In total, 138 patients underwent HoLEP with mean age of 74.59 ± 9.96 (56–90) years and a median of 75 years. The mean preoperative prostate volume was 59.61 ± 18.86 (30–180) ml. The average operative time was 103.03 ± 31.07 (50–150) min. The resected weight was 55.75 ± 19.04 g with a delivered energy of 186.3 ± 52.4 kJ. The duration for keeping urethral catheters and hospitalization were 1.1 (1–2) and 1.4 (1–4) days. Eighteen patients experienced at least one perioperative complication of which four were converted to TURP and two required bladder clot evacuation. Twenty patients had postoperative complications including of which eleven required urethral catheter reinsertion. There was a significant improvement in IPSS and Qmax at the 3rd month postoperative review. Conclusion: HoLEP is a promising technique that has proven to be safe and reproducible. Through the analysis of our results we have shown the presence of a learning curve and predictive values of some clinical features to optimize patients care.

African Journal of Urology (2017) 23, 245–248