Efficacy analysis of 450 nm semiconductor blue laser enucleation of the prostate in treating benign prostatic hyperplasia with urinary retention.

To evaluate the clinical efficacy of 450 nm semiconductor blue laser enucleation of the prostate in patients with benign prostatic hyperplasia (BPH) complicated by acute urinary retention, and to assess its outcomes in patients with concomitant detrusor underactivity (DU).A retrospective analysis was conducted on clinical data from patients diagnosed with BPH and acute urinary retention who underwent 450 nm blue laser enucleation of the prostate in the Department of Urology at our hospital between February 2023 and May 2024. All patients had indwelling catheters due to acute urinary retention prior to surgery. Maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), International Prostate Symptom Score (IPSS), and quality of life (QoL) scores were compared before surgery and at 3 months postoperatively. Based on preoperative urodynamic testing, patients were divided into a DU group (bladder contractility index, BCI < 100) and a non-DU group (BCI ≥ 100). Surgical outcomes were compared between the two groups.A total of 62 patients were included in the study, with a mean age of 71.5 years. Of these, 32 (54.8%) were in the DU group and 28 (45.2%) in the non-DU group. At 3 months postoperatively, all patients showed significant improvements in Qmax, PVR, IPSS, and QoL scores compared with baseline (P < 0.001). In the DU group, 2 patients experienced recurrent urinary retention after catheter removal on postoperative day 3, but both recovered spontaneous urination after re-catheterization for 1 week. Intergroup comparisons showed that Qmax was lower and PVR was higher in the DU group than in the non-DU group at 3 months (P < 0.001), while no significant differences were observed in IPSS and QoL scores between the two groups (P > 0.05).The 450 nm semiconductor blue laser enucleation of the prostate is a safe and effective treatment for BPH complicated by acute urinary retention. Although patients with DU show less improvement in early postoperative voiding function compared to those without DU, the procedure effectively alleviates symptoms and may prevent further deterioration of detrusor function. These findings support its clinical application and wider adoption.