HoLEP after prostate biopsy: does it have any impact?

Area of Science:

• Urology
• Surgical Oncology

Background:

• Holmium laser enucleation of the prostate (HoLEP) is a leading surgical treatment for benign prostatic hyperplasia (BPH).
• Concerns exist regarding the safety and outcomes of HoLEP following a recent prostate biopsy due to potential inflammation or tissue changes.

Purpose of the Study:

• To evaluate the perioperative and postoperative outcomes of HoLEP in patients who have undergone a prostate biopsy.
• To determine the optimal timing for HoLEP surgery after a prostate biopsy.

Main Methods:

• Retrospective review of 160 patients undergoing HoLEP by a single surgeon.
• Patients were divided into two groups: 80 without prior prostate biopsy and 80 with prior prostate biopsy (HoLEP performed at least 2 weeks post-biopsy).
• Comparison of enucleation time, laser efficiency, morcellation time, hospitalization, catheterization duration, and complication rates.

Main Results:

• No significant differences were observed in enucleation time, laser efficiency, hospitalization, or catheter removal time between groups.
• Morcellation time was shorter in patients without a prior biopsy.
• Postoperative outcomes, including continence status and Clavien grade 4+ complications, were similar. Urinary tract infections were not significantly different between groups.

Conclusions:

• HoLEP is a safe and effective procedure for patients with a history of prostate biopsy.
• HoLEP can be safely performed as early as two weeks after a prostate biopsy without compromising outcomes.