Evolution of the medium-term functional outcomes of holmium laser prostate enucleation (HoLEP).

INTRODUCTION

The boom in surgery for benign prostatic hyperplasia using Holmium laser enucleation (HoLEP) has reduced length of hospitalization, catheterization duration and the risk of bleeding, with comparable results to the old gold standard. The aim of this study is to evaluate the evolution of medium-term functional results after HoLEP.

METHOD: Retrospective monocentric observational study in patients who underwent HoLEP surgery from 2014 to 2019. We analyzed our post-operative functional results (scores USP, IPSS, QoL and Qmax) at short and medium term. The results were compared to preoperative data. At last consultation was performed at least one year after the procedure.

RESULTS

A total of 338 patients underwent HoLEP surgery during this period. The mean follow-up time at the last consultation was 3.5 years. At the last consultation, the USP was 0.5 for the dysuria score (a 2.7-point improvement) (P<0.001), 1.6 points for the overactive bladder score (a 3.9-point improvement) (P<0.001), 0.5 for the stress urinary incontinence score (a 0.1-point improvement) (P=0.67). Among the patients, 2% had severe urinary incontinence (Stress urinary incontinence USP≥7). The average IPSS at the last consultation was 3.7, an improvement of 16 points compared with the pre-operative score (P<0.001), and the average QoL was 1, an improvement of 4.3 (P<0.001).

CONCLUSION

Surgical treatment of benign prostatic hyperplasia using HoLEP appears to be an efficient technique at medium term with a 2% rate of severe stress urinary incontinence. Overactive bladder is corrected from the 6th month postoperatively.