Holmium laser enucleation of the prostate improves the renal insufficiency of benign prostatic hyperplasia with hydronephrosis.

BACKGROUND

Hydronephrosis is a serious long-term complication of benign prostatic hyperplasia (BPH), and patients with this condition are prone to suffer from renal insufficiency. This study was performed to evaluate the efficacy of holmium laser enucleation of the prostate (HoLEP) for renal dysfunction in BPH patients with hydronephrosis.

METHODS

In this retrospective cohort study, the enrolled 122 patients were divided into two groups according to the type of surgery: HoLEP (n=64) or bipolar plasmakinetic transurethral resection of the prostate (TURP, n=58). Perioperative indicators and follow-up variables were analysed to evaluate the efficacy and durability of HoLEP.

RESULTS

The HoLEP group had a shorter operation time, bladder irrigation time, catheterization duration and hospital stays; less haemoglobin (Hb) and sodium decrease; and greater tissue removal (P<0.01). Improvements in the International Prostate Symptom Score (I-PSS), postvoid residual, maximum urinary flow rate, hydronephrosis and renal dysfunction in the HoLEP group were more evident during the entire follow-up period (P<0.01).

CONCLUSIONS

Therefore, by more safely and completely removing the hyperplastic prostate tissue to ensure durable relief of lower urinary tract obstruction, HoLEP can effectively and continuously benefit the recovery of renal function in BPH patients with preoperative hydronephrosis, and it is expected to become the ideal surgical intervention for these patients.