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Updated: Jul 12, 2025
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
Published on: March 6, 2018
Same-day catheter removal after holmium laser enucleation of the prostate (HoLEP): a systematic review
Theodoros Spinos1, Vasileios Tatanis1, Evangelos Liatsikos1,2
1Department of Urology, University of Patras Hospital, 26504, Patras, Greece.
Insights
Same-day catheter removal after Holmium Laser Enucleation of the Prostate (HoLEP) is feasible, safe, and effective for select patients. Factors like furosemide improve success, while preoperative PVR and retention predict failure.
Area of Science:
- Urology
- Surgical Innovation
- Patient Outcomes
Background:
- Holmium Laser Enucleation of the Prostate (HoLEP) is a common BPH treatment.
- Current practice often involves delayed catheter removal post-HoLEP.
- Evidence on same-day catheter removal post-HoLEP is synthesized.
Approach:
- Systematic literature search of PubMed, Scopus, and Cochrane databases.
- Adherence to PRISMA guidelines for systematic reviews.
- Qualitative synthesis of six included studies (four retrospective, two prospective).
Key Points:
- Same-day catheter removal success rates ranged from 85.5% to 90%.
- Only one unrelated grade-IIIb Clavien-Dindo complication reported.
- Intraoperative furosemide administration improved same-day catheter-free rates.
Conclusions:
- Same-day catheter removal is a viable strategy for selected HoLEP patients.
- Preoperative PVR and urinary retention are predictors of trial of void failure.
- This approach enhances efficiency and potentially patient recovery.
Purpose:
To summarize all existing evidence regarding the feasibility, safety, and efficacy of same-day trial of void and catheter removal after Holmium Laser Enucleation of the Prostate (HoLEP). Although there have been many reports of the safety and efficacy of same-day discharge from the hospital for selected patients undergoing HoLEP, in most of these reports, patients return to the hospital, usually on postoperative day one, to undergo a trial of void and catheter removal.
Methods:
PubMed®, Scopus®, and Cochrane® primary databases were systematically screened, from inception to 17 January 2023. The search strategy used the PICO (Patient, Intervention, Comparison, Outcomes) Framework. We followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results:
Six studies met all the predefined criteria and were included in the final qualitative synthesis. Four studies were retrospective and two were prospective. Four studies were non-comparative, while two were comparative ones. The same-day catheter removal success rate ranged from 85.5 to 90% among studies, while only one grade-IIIb Clavien-Dindo complication was reported, which was unrelated to surgery.
Conclusion:
Same-day catheter removal is a feasible, safe, and efficient approach for selected patients undergoing HoLEP. Certain factors, such as intraoperative furosemide administration, were found to improve same-day catheter-free rates, while preoperative PVR and urinary retention were independent predictive factors of same-day trial of void failure.
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