To analyze the long-term efficacy and safety of Holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH).
A total of 127 patients who underwent HoLEP at our institution between 2013-2015 were included. Patients were observed for 5 years post-operatively. We evaluated the length of the surgery, the mass of the removed tissue, PSA level, the maximal flow rate (Qmax), post-void residual (PVR), the length of catheterization and hospitalization, and the IPSS and IPSS-QoL at each clinic visit.
PVR, Qmax, IPSS and QOL all improved significantly immediately after the operation (p <0.001). By the end of the 5th postoperative year, all the parameters showed a statistically meaningful decline: Qmax reduced by 5.8 ml/s (22.6%) and IPSS by 1.4 points (29.1%). 8.6% of the patients continued therapy with Alpha-blockers. There were no differences in efficacy by the age of the patients or the volume of the prostate. Long-term complications and need for repeat operations were not affected by the volume of the prostate or patient age.
The improvement of PVR, Qmax, IPSS and QOL score seen in the early postoperative period after performing HoLEP remains evident at 5 years post-operatively. Long-term complications and the need for reoperation do not depend on the age of the patient or on the initial volume of the prostate.
Journal of endourology. 2020 Jun 27 [Epub ahead of print]
Dmitry Enikeev, Mark Sergeevich Taratkin, Andrei Morozov, Nirmish Singla, Svetlana Gabdulina, Alexander Tarasov, Roman Borisovich Sukhanov, Juan Gómez Rivas, Ekaterina Laukhtina, Magomed Arshiev, Vasiliy Mikhailov, Petr Vitalievich Glybochko
Sechenov University, 68477, Institute for Urology and Reproductive Health, Moskva, Moskva, Russian Federation; ., Sechenov University, Institute for Urology and Reproductive Health, 2/1 Bolshaya Pirogovskaya St., Moscow, Russian Federation, 119991; ., Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russian Federation; ., UT Southwestern Medical, 89063, Department of Urology, Dallas, Texas, United States; ., Sechenov University, 68477, Institute of Linguistics and Intercultural Communication, Moskva, Moskva, Russian Federation; ., Sechenov University, Institute of Linguistics and Intercultural Communication, Moscow, Russian Federation; ., Sechenov University, 68477, Institute for Urology and Reproductive Health, Moskva, Moskva, Russian Federation; ., Hospital Universitario La Paz, Department of Urology, Madrid, Madrid, Spain; ., Sechenov University, 68477, Institute for Urology and Reproductive Health, Moskva, Moskva, Russian Federation; ., Sechenov University, 68477, Moskva, Moskva, Russian Federation; ., Sechenov University, 68477, Institute for Urology and Reproductive Health, Moskva, Moskva, Russian Federation; ., Sechenov University, 68477, Institute for Urology and Reproductive Health, Moskva, Moskva, Russian Federation; .