Category: BPH/LUTS: Outcomes & Complications
Introduction & Objective : A major development in the surgical treatment of benign prostatic hyperplasia is seen nowadays. The objective of this study was to evaluate complications of Holmium LASER enucleation of the prostate technique (HoLEP) and the risk factors that urologists need to know.
Methods : We retrospectively studied all HoLEP procedures performed between January 1, 2012 and December 31, 2016. The pre-operative characteristics of the patients (Age, BMI, ASA score, estimated prostate volume, PSA, IPSS, presence of a preoperative catheter, indication for surgery, platelet antiaggregant or anticoagulant), perioperative data (duration of intervention, catheterization, hospital stay, transfusion rate, histopathological findings , postoperative complications, catheterization at discharge) were collected. Univariate analyzes were performed to investigate risk factors for complications.
1201 patients were included. The overall complication rate was 19.15%. The transfusion rate was 3.7%. Age (p = 0.019), ASA score> 2 (p = 0.0019), prostate volume (p = 0.011), anticoagulant intake (p<0.0001), low pre and post-operative hemoglobin (p = 0.034 and p <0.0001), poor operative experience (p= 0.0048), and long operative time (p = 0.0144) were found to be risk factors for complications.
Conclusions : HoLEP is a safe technique with a limited risk of complications and an acceptable recovery if the patients are well selected.