Safety and Efficacy of Holmium Laser Enucleation of the Prostate Within Two Weeks of Transrectal Ultrasound-Guided Prostate Biopsy.

BACKGROUNDS: To evaluate the safety and efficacy of Holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia when performed within 2 weeks after a transrectal prostate biopsy (PB).

METHODS

A retrospective study was conducted on 153 patients undergoing HoLEP between March 2020 and April 2023. The cohort was divided into two groups based on the interval between PB and HoLEP: 67 patients underwent HoLEP within 2 weeks post-PB, and 86 patients underwent HoLEP more than 2 weeks post-PB. Baseline characteristics and perioperative parameters were documented, including enucleation efficiency (EE), catheter time, hospital stay, and hemoglobin reduction. All patients were followed up at 1, 6, and 12 months postoperatively, with assessments of maximum urinary flow rate (Q max), postvoid residual volume (PVR), International Prostate Symptom Score (IPSS), and quality of life (QoL) score. Perioperative and postoperative complication rates were recorded. Spearman's correlation analysis was applied to explore the relationship between the PB-to-HoLEP interval and both perioperative parameters and functional outcomes.

RESULTS

Baseline parameters were comparable between groups. No significant differences were observed in perioperative parameters or complication rates between groups. Postoperative outcomes (Q max, PVR, IPSS, QoL score) in both groups showed significant improvements compared to baseline values; however, these improvements did not differ significantly between groups. Spearman's correlation analysis revealed no significant association between the PB-to-HoLEP interval and perioperative parameters, nor with postoperative changes in functional outcomes (delta IPSS, delta Q max, delta PVR).

CONCLUSION

HoLEP within 2 weeks of transrectal PB does not adversely affect surgical safety or outcomes.