[Complications of the holmium laser enucleation of prostate for benign prostatic hyperplasia]

Urologiia. 2018 Mar:(1):42-47.
[Article in Russian]

Abstract

Introduction: With growing experience in the HoLEP, it can replace TURP as the "gold standard" for the surgical management of BPH, and therefore this technique is the most studied surgical modality. Despite the proven effectiveness of HoLEP in the treatment of patients with BPH, its widespread use has been associated with both intra- and postoperative complications.

Aim: To improve the results of surgical management of patients with BPH.

Material and methods: The study comprised 310 patients who underwent HoLEP for BPH. HoLEP was performed using the Gillings technique.

Inclusion criteria: presence of LUTS (Qmax<15 ml/s, Qav<10 ml/s, presence of residual urine, I-PSS score> 5, QoL score> 2), absence of an active inflammatory process of the urogenital organs.

Results: Intraoperative complications included severe hemorrhage in 16 (5.2%), the bladder wall injury in 17 (5.5%) and the ureteral orifice injury in 2 (0.6%) patients. 275 (88.7%) had no intraoperative complications. Early postoperative complications included fever in 4 (1.3%), the bladder tamponade that required cystoscopy and evacuation of blood clots in 7 (2.3%) and acute urinary retention in 36 (11.8%) patients. 263 (84.6%) patients had no postoperative complications. Long-term postoperative complications comprised urinary incontinence in 39 (12.6%) patients and urethral strictures requiring surgical treatment in 9 (2.9%) patients. There were no long-term complications in 262 (84.5%) patients.

Conclusion: HoLEP is an effective and safe surgical modality for treating patients with BPH with minimal complications, suitable for any size of the prostate.

Keywords: HoLEP; LUTS; prostatic hyperplasia; transurethral resection of prostatic hyperplasia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Humans
  • Intraoperative Complications / etiology*
  • Laser Therapy / adverse effects*
  • Laser Therapy / methods
  • Lasers, Solid-State / adverse effects*
  • Lasers, Solid-State / therapeutic use
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Prospective Studies
  • Prostatic Hyperplasia / surgery*
  • Quality of Life
  • Treatment Outcome
  • Urodynamics