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Holmium laser enucleation for large (greater than 100 mL) prostate glands
Janaka A Hettiarachchi1, Albert A Samadi, Sensuke Konno
1Department of Urology, New York Medical College, Valhalla 10595, USA.
Background:
To evaluate the holmium laser enucleation of the prostate (HoLEP) using the transurethral soft tissue morcellator (TUSTM), as a primary surgical treatment for symptomatic benign prostatic hyperplasia (BPH) with prostate glands > 100 mL.
Methods:
Eighteen patients with preoperative prostate volumes > 100 mL underwent the HoLEP procedure. The criteria for surgery were determined by a preoperative International Prostate Symptom Score (IPSS), a prior failure of medical therapy, and urinary retention.
Results:
The mean preoperative IPSS and prostate gland size were 13.8 and 142.3 mL, respectively. The total energy used by the laser was 288.4 kJ. The mean catheter time was 23.8 h and, perioperatively, no patients had electrolyte abnormalities or required blood transfusions. The 3-week postoperative IPSS was 2.8, with minimum long-term complications.
Conclusions:
Holmium laser enucleation of the prostate with TUSTM is a safe and effective alternative to open prostatic surgery for glands > 100 mL.