Category: Basic Science: BPH/LUTS
Introduction & Objective :
Meta-analyses and well-designed randomized controlled trials have confirmed how well established holmium laser enucleation of the prostate (HoLEP) for treatment of benign prostatic hyperplasia (BPH). HoLEP showed superior efficacy compared to the traditional transurethral resection of the prostate. The preliminary data and randomized trial comparing HoLEP and TURP were Previously reported with subsequent multiple publications from our institution. The long-term data and further analysis of these patients are now presented.
Between March 1998 and March 2016, a prospectively collected database for patients undergoing HoLEP for symptomatic BPH performed by single expert surgeon was reviewed. Demographic and perioperative data were collected together with the International Prostate Symptoms Score (IPSS), Quality of Life (QoL), peak flow rate (Qmax), residual urine (PVR), and PSA changes. In addition, perioperative and late adverse events were recorded.
Demographic and perioperative data are presented in table 1. Aftera mean follow-up of 11.2 years (2-18 years), 1455 patients were included with a mean age of 68.9 (range: 53- 86) years. The mean catheter time and hospital stay were 1.2 and 1.3 days, respectively. The IPSS (15.9± 6.5 vs. 6.8± 5.6, pTable 2). No patient needed perioperatve blood transfusion while 60 patients (4.1%%) were found to have incidental prostse cancer. Compared to its preoperatve values, follow-up PSA has been reduced by 66.7% (p
Conclusions : Holmium laser enucleation of the prostate is safe, effective and durable for benign prostatic hyperplasia over long follow-up
Ahmed Ibrahim– Endourology Fellow, McGill University Health Centre, Montreal, Quebec, Canada
Mohannad Alharbi– Montreal, Quebec, Canada
Mostafa Elhilali– McGill University Health Centre, Montreal, Quebec, Canada
Serge Carrier– McGill University Health Centre, Montreal, Quebec, Canada
McGill University Health Centre
Montreal, Quebec, Canada
Dr. Ahmed Ibrahim is an Endourology clinical research fellow at McGill University Health Centre, Montreal, QC, Canada. He graduated from Al-Azhar medical school, Cairo, Egypt where he completed his urology residency training program in 2016.
His Current research interests include role of virtual reality simulators in surgical educations, minimally invasive treatment of urinary tract stones and role of different lasers in management of bladder outlet obstruction.