The Outcomes Of Holmium Laser Enucleation Of Prostate In Benign Prostatic Hyperplasia Patients With Voiding And Storage Lower Urinary Tract Symptoms: A Comparative Study.
Posted Date: Jan 31, 2022
- Investigator: Mostafa Mostafa
- Type of Study: Observational/Survey
Purpose: To compare the outcomes of holmium laser enucleation of prostate (HoLEP) in benign prostatic hyperplasia (BPH) patients with voiding versus storage symptoms. Methods/Materials: This is a retrospective chart review of BPH patients who underwent HoLEP for either voiding or storage LUTS from February 2015 to December 2020. Our inclusion criteria included patients with BPH who underwent HoLEP for either predominant voiding or storage symptoms. We excluded patients who underwent the procedure for BPH with concomitant bladder stones, gross hematuria, and/or neurogenic bladder. We also excluded patients with predominant storage LUTS and postvoid residual volumes of 150 ml or more, patients taking medications that may mimic or aggravate the LUTS, and those having uncontrolled diabetes mellitus (DM) or recurrent urinary tract infections (UTIs). Patients’ characteristics, preoperative symptomatology, preoperative urodynamics study (UDS) parameters, preoperative International Prostate Symptom Score (IPSS), postoperative symptomatology, IPSS, procedure complications and postoperative need for further treatment were collected, analyzed, and compared. Results: A total of 132 patients were included in the analysis. Patients were divided into two groups based on patient’s predominant symptomatology: Group 1 included patients with predominant voiding symptoms (68 Patients) while group 2 involved those with predominant storage symptoms (64 Patients). HoLEP was equally effective in symptom improvement of both groups with no significant difference in the postoperative decrease in IPSS between both groups. This was true at both 3-month (P-value=0.842) and 6-month (P-value=0.483) follow-up even though the IPSS was significantly higher in group 1 than in group 2 preoperatively (P-value=0.010) (Table). Conclusion: HoLEP has a comparable efficacy in management of patients with either predominant voiding or storage symptoms yielding equivalent rates of postoperative patient satisfaction as evidenced by the proportionate improvement in IPSS between both groups.
Holmium Laser Enucleation Of Prostate (Holep), Benign Prostatic Hyperplasia (Bph)
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Mostafa M. Mostafa, Md
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