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Open Access 01-09-2021 | Prostate Cancer | Original Article

Efficacy, safety, and perioperative outcomes of holmium laser enucleation of the prostate—a comparison of patients with lower urinary tract symptoms and urinary retention

Authors: Pawel Trotsenko, Christian Wetterauer, Philipp Grimsehl, Tilmann Möltgen, Susan Meierhans, Lukas Manka, Helge Seifert, Stephen Wyler, Maciej Kwiatkowski

Published in: Lasers in Medical Science | Issue 7/2021

Abstract

Holmium laser enucleation of the prostate (HoLEP) is a valid treatment option to relieve bladder outlet obstruction in patients with large prostate volumes (PV). Its efficacy, tolerability, and safety are comparable to the ones of other laser treatments of the prostate and resection techniques. However, safety and efficacy of HoLEP have not been compared between patients with and without preoperative urinary retention. We included 350 patients (mean age 71.2 years) who had undergone HoLEP due to lower urinary tract symptoms (LUTS) or urinary retention caused by prostatic hyperplasia. We evaluated the differences in peri- and postoperative outcomes and complications between patients with and patients without preoperative urinary retention. The mean PV was 115 cm³. PV was > 100 cm³ in 61.9% and < 100 cm³ in 38.1% of the patients. Perioperative complications occurred in 23 patients (6.6%), 15 of which (4.3%) required operative revision. We found no significant differences in terms of complication rates between patients with PV > 100 cm³ and patients with PV < 100 cm³. Mean catheterization-duration was 3.3 days. Preoperatively, 140 patients (40%) had a suprapubic or transurethral indwelling catheter; they did not differ from patients without preoperative catheter regarding postoperative catheter removal success rate, early postoperative complications, and functional outcomes. Prostate cancer was diagnosed in 43 patients (12.3%). Median postoperative PSA-decline was 6.1 ug/l (89.8% drop). HoLEP is a safe and effective treatment for patients with LUTS or urinary retention and large PV. PV > 100 cm³ was not associated with higher complication rates or successful catheter-removal. Furthermore, functional outcomes were independent of preoperative catheterization.

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Title: Efficacy, safety, and perioperative outcomes of holmium laser enucleation of the prostate—a comparison of patients with lower urinary tract symptoms and urinary retention
Authors: Pawel Trotsenko
Christian Wetterauer
Philipp Grimsehl
Tilmann Möltgen
Susan Meierhans
Lukas Manka
Helge Seifert
Stephen Wyler
Maciej Kwiatkowski
Publication date: 01-09-2021
Publisher: Springer London
Keywords: Prostate Cancer
Prostate Cancer
Laser
Published in: Lasers in Medical Science / Issue 7/2021
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-020-03170-4

Keynote webinar | Spotlight on medication adherence

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Efficacy, safety, and perioperative outcomes of holmium laser enucleation of the prostate—a comparison of patients with lower urinary tract symptoms and urinary retention

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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