Minimally invasive laser enucleation of the prostate (MiLEP) in a patient with prior EPA urethroplasty and an indwelling "Butterfly" prostatic retractor device: A case report.

We present the first reported case of holmium laser enucleation of the prostate (HoLEP) in a patient with a mucosa-embedded nitinol-based "Butterfly" prostatic retractor device and a prior Excision and Primary Anastomosis urethroplasty for bulbar stricture. Using a 22Fr minimally invasive resectoscope (MiLEP), the device was fragmented with the laser and extracted in its entirety. Prostatic enucleation and morcellation were successfully and safely completed. Morcellation is feasible but requires caution due to device interference. This study demonstrates the feasibility of small-caliber MiLEP in patients with complex anatomy and implanted prostatic devices, expanding minimally invasive options for surgically challenging BPH cases.