Holmium laser resection of the prostate (HoLRP): 2-year follow-up data

The aim of this study was to evaluate the 2-year clinical outcome of patients who underwent holmium laser resection of the prostate (HoLRP) for management of benign prostatic hyperplasia (BPH).

All patients who underwent HoLRP before October 1995 were contacted by mail. Each patient completed an American Urological Association (AUA) symptom score index, a questionnaire, and a urinary flow rate. The questionnaire was used to evaluate the frequency of complications, incontinence, recatheterization, and patient satisfaction.

Two hundred twelve patients were contacted and 168 responded. Of these, 100 patients successfully completed all three investigations and had all preoperative information available. Mean length of follow-up was 27.5 months (range 24 to 34 months). Mean peak urinary flow was 21.6 mL/s (range 6 to 34 mL/s), mean voided volume was 348 mL (range 146 to 1,387 mL), and mean AUA symptom score index was 6.8 (range 0 to 27). Eighty-eight percent of patients stated they would have HoLRP again for management of their BPH. The perioperative recatheterization rate was 9%. Reoperation rate with a minimum of 2 years of follow-up was 5%; three patients required a bladder neck incision and two patients required a revision HoLRP. Urethral strictures occurred in 4% of patients, and 1% of patients had persistent incontinence requiring pads.

Medium-term clinical results of HoLRP confirm that patient satisfaction is excellent, with complication rates similar to those historically reported for transurethral resection of the prostate (TURP). The HoLRP technique is an effective and durable surgical alternative to standard TURP.