Holmium Laser Enucleation of Prostate for Benign Prostatic Hyperplasia: Seoul National University Hospital Experience

Bae, Jungbum; Choo, Minsoo; Park, Ji Hyun; Oh, Jin Kyu; Paick, Jae Seung; Oh, Seung June

Abstract

PURPOSE
The objective of this study was to report the experience acquired at the Seoul National University Hospital with Holmium Laser Enucleation of Prostate (HoLEP), combined with mechanical morcellation for symptomatic benign prostatic hyperplasia (BPH).
METHODS
A retrospective review was performed on the clinical data of 309 consecutive patients who underwent HoLEP at our institution between July 2008 and June 2010. All patients were evaluated preoperatively for prostate volume by transrectal ultrasound, maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS) and quality of life (QoL) score. Peri- and postoperative parameters were evaluated and patients were followed-up at 1-, 3-, 6-, and 12- months with the aforementioned investigations.
RESULTS
The patients' mean age was 68.3 (+/-6.5) years and mean prostate volume was 55.6 (+/-23.6) mL. Mean enucleation time was 56.2 (+/-25.1) minutes, mean morcellation time was 11.3 (+/-9.5) minutes, and the mean resected weight of the prostate was 20.8 (+/-16.9) g. The mean catheter indwelling period was 1.9 (+/-1.7) days and mean hospital stay was 2.9 (+/-1.5) days. Significant improvement was noted in Qmax, IPSS, and QoL at the 1-year follow-up compared with baseline (P<0.01). At 1 month 17.2% of patients complained of irritative urinary symptoms, which were typically self-limiting within 3 months. Transient stress incontinence was reported in 15.2% of patients. No patient experienced persistent obstructive symptoms that required reoperation.
CONCLUSIONS
Our study showed that HoLEP is a safe and effective therapeutic modality for BPH.