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Updated: May 13, 2026
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).
Published on: March 6, 2018
Postoperative infectious complications in our early experience with holmium laser enucleation of the prostate for
Katsumi Shigemura1, Kazushi Tanaka, Takahiro Haraguchi
1Division of Urology, Department of Organs Therapeutics, Kobe University Graduate School of Medicine, Kobe, Japan.
Purpose:
The objective of this study was to retrospectively investigate postoperative infectious complications (PICs) in our early experience with holmium laser enucleation of the prostate (HoLEP) followed by mechanical morcellation for symptomatic benign prostatic hyperplasia.
Materials And Methods:
A retrospective review was performed of the clinical data for 90 consecutive patients who underwent HoLEP at our institution between February 2008 and March 2011. All patients were evaluated for the emergence of PICs, including prophylactic antibiotic administration (PAA) and the influence of the kind or duration of PAA on PIC. The details of cases with PICs were also examined.
Results:
The patients' mean age was 71 years (range, 50 to 95 years), and their mean prostate volume was 60 mL (range, 2 to 250 mL). There were 7 cases (7.78%) with PICs; in detail, 3 patients were diagnosed with prostatitis, 2 with pyelonephritis, and 2 with epididymitis. Three patients had positive urine cultures: 1 had Serratia marcescens/Proteus mirabilis, 1 had S. marcescens, and 1 had Klebsiella pneumonia; only one case had urological sepsis. Our statistical data showed no significant differences between 2 or fewer days and 3 or more days of PAA and PIC occurrence. There was also no significant effect on PIC occurrence of sulbactam/ampicillin compared with other antibiotics.
Conclusions:
The results of this retrospective study showed that PIC occurrence did not depend on the duration or the kind of PAA. Further prospective study is necessary for the evaluation and establishment of prophylactic measures for PICs.
Insights
Postoperative infectious complications (PICs) after holmium laser enucleation of the prostate (HoLEP) did not significantly correlate with the duration or type of prophylactic antibiotic administration (PAA). Further research is needed to establish optimal prophylactic measures.
Area of Science:
- Urology
- Surgical Oncology
- Infectious Diseases
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Holmium laser enucleation of the prostate (HoLEP) followed by mechanical morcellation is an effective treatment for symptomatic BPH.
- Postoperative infectious complications (PICs) are a potential concern after HoLEP.
Purpose of the Study:
- To retrospectively investigate the incidence of PICs in early HoLEP cases.
- To evaluate the influence of prophylactic antibiotic administration (PAA) on PICs.
- To examine the impact of PAA duration and type on PIC occurrence.
Main Methods:
- Retrospective review of 90 consecutive patients undergoing HoLEP.
- Analysis of clinical data, focusing on PICs and PAA details.
- Statistical evaluation of PAA duration (≤2 days vs. ≥3 days) and antibiotic type.
Main Results:
- A total of 7.78% of patients (7/90) experienced PICs, including prostatitis, pyelonephritis, and epididymitis.
- Three patients had positive urine cultures; one case of urological sepsis was reported.
- No significant difference in PIC occurrence was found based on PAA duration or antibiotic type.
Conclusions:
- PIC occurrence after HoLEP was not significantly influenced by the duration or type of PAA in this early experience.
- Further prospective studies are required to determine optimal prophylactic strategies for PICs.
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