No bladder irrigation versus continuous bladder irrigation after HoLEP: a propensity score matching analysis

Area of Science:

• Urology
• Surgical Innovation
• Patient Outcomes

Background:

• Benign prostatic hyperplasia (BPH) is a common condition requiring effective treatment.
• Transurethral holmium laser enucleation of the prostate (HoLEP) is a standard surgical option for BPH.
• Post-operative bladder irrigation is a common practice after HoLEP, but its necessity is debated.

Purpose of the Study:

• To evaluate the feasibility and safety of a no bladder irrigation strategy following HoLEP for BPH.
• To compare clinical outcomes and complications between patients with and without post-HoLEP bladder irrigation.

Main Methods:

• A retrospective study comparing 62 patients who did not receive bladder irrigation (Group A) with 150 patients who did (Group B) after HoLEP.
• Propensity score matching (PSM) was used to ensure baseline comparability between groups.
• Key outcome measures included pre- and post-operative International Prostate Symptom Score (IPSS), Quality of Life (QOL), maximum urinary flow rate (Qmax), postvoid residual urine (PVR), and complication rates.

Main Results:

• PSM successfully matched 47 pairs of patients, showing no significant differences in intraoperative conditions or early post-operative complications.
• Both groups showed significant improvements in IPSS, QOL, Qmax, and PVR one month after surgery.
• No statistically significant differences in IPSS, QOL, Qmax, PVR, or early complications were observed between the groups within one month post-surgery.

Conclusions:

• The no bladder irrigation strategy after HoLEP for BPH is a safe and effective option for carefully selected patients.
• This approach can potentially streamline post-operative care without compromising patient outcomes.
• Further research may support wider adoption of this simplified post-operative regimen.