Holmium laser enucleation of the prostate (HoLEP) is an effective treatment for benign prostatic hyperplasia (BPH) that has long-term durable clinical outcomes, researchers concluded.
In addition, the procedure is associated with little complication risk and has a reoperation rate of 0.7% at 10-year follow-up, a rate lower than the 10%-16% rate associated with transurethral resection of the prostate (TURP), the current gold standard.
The study, by researchers at McGill University in Montreal led by Mostafa M. Elhilali, MD, included 949 patients treated with HoLEP over a 12-year period.
Patients had a mean preoperative post-void residual volume of 311 mL, maximal flow rate of 7.9 mL/sec, and an International Prostate Symptom Score (IPSS) of 19. Postoperatively, all variables showed significant improvement beginning after one month of follow-up remained improved for the entire follow-up period, the researchers reported in the Journal of Urology (2011;186:5;1972-1976). At 10 years, mean postoperative post-void residual volume was 52 mL, mean maximal flow rate was 23.4 mL/sec, and mean IPSS was 3.8. A total of 343 men (36%) experienced acute urinary retention.
The researchers observed persistent urge and stress incontinence in 1% and 0.5% of patients, respectively. Bladder neck contracture, urethral stricture and reoperation because of residual adenoma developed in 0.8%, 1.6% and 0.7% of patients, according to the investigators.