Category: Basic Science: BPH/LUTS
Introduction & Objective : To evaluate the effects of holmium laser enucleation of prostat (HoLEP) in patients with ≤80 mL and >80 mL.
We retrospectively reviewed 119 consecutive patients who underwent HoLEP procedure for LUTS/BPH between June 2015 and December 2017. The patients were divided two groups depending on prostate size (PS) on abdominal ultrasonography: Group 1 (PS ≤80 g, n:58), Group 2 (PS >80 g, n:61). International Prostate Symptom Score (IPSS), Quality of Life (QoL), Qmax, average urinary flow rate (Qave), PVR, voiding time (VT), time to maximum of voiding (MVT) were noted pre and postoperatively (3 months after surgery). Enuclation rate (ER) was calculated by the ratio of the amount of removed tissue to the transizional zone size. Enuclation time (ET), morcelation time (MT), total operation time (TOT), total laser energy (TLE), efficiency of laser (EL-joule/gram), efficiency of enucleation (EE-gram/min), Efficiency of Morcellation (EM- gram/min) hemoglobin decrease, enuclated tissue weight (ETW), complication rate (CR), hospitalization time (HT), catheterization removal time (CRT) were recorded.
The mean age of the patients was 62,76±8,42 years in Group 1, 65,9±8,52 years in Group 2. There was no significantly differences in terms of age, Hb decrease, IPSS, QoL, Qmax, Qave, PVR, VT, MVT between groups, preoperatively. In preoperative evaluation, PSA and prostate volume were significantly different in both groups (p: 0,001).
In both groups, IPSS, QoL, PVR and VT significantly decreased and Qmax and Qave significantly increased postoperatively. In terms of MVT, there was no difference in Group 1 compared pre and postoperatively, but it was lower in Group 2.
When compared two groups according to the postoperative outcomes, IPSS, QoL, Qmax, Qave, PVR, VT, Hb decrease, EE, ER, EL, CR were similar in both groups. In group 2, ETW, ET, MT, TOT, TLE, HT and CRT were higher compared with group 1.
Conclusions : HoLEP is an effective treatment method for small prostates as well as large prostates. It can be expected to be gold standard therapy, not only large prostate, but also all prostate size. Further clinical studies wtih large series are needed to make some inferences.
Eymen Gazel– Urologist, acibadem, Ankara, Ankara, Turkey
Engin Kaya– Urologist, Ankara, Ankara, Turkey
Serdar Yalcin– Urologist, Ankara, Ankara, Turkey
Halil Cagri Aybal– Urologist, Ankara, Ankara, Turkey
Tahsin Batuhan Aydogan– Urologist, Goksun, Kahramanmaras, Turkey
Lutfi Tunc– Urologist, Gazi University School of Medicine Dept. of Urology, Ankara, Ankara, Turkey
Ankara, Ankara, Turkey
Im working İn Acibaem University Ankara hospital as Asist.Prof in Ankara,Turkey