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Updated: Sep 19, 2025
06:04
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.
Published on: March 6, 2018
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Delayed Urinary Retention After Holmium Laser Enucleation of Prostate.
Maithili Gopalakrishnan1, Anastasija Useva1, Raj Kumar1
1Department of Urology, SUNY Upstate Medical University, Syracuse, NY.
Urology
|June 15, 2025
Summary
Intraoperative urethral dilation and postoperative continuous bladder irrigation are key risk factors for delayed urinary retention after holmium laser enucleation of the prostate (HoLEP). Avoiding these may reduce complications and unplanned visits.
Area of Science:
- Urology
- Surgical Outcomes
- Postoperative Complications
Background:
- Delayed urinary retention (DUR) can occur after holmium laser enucleation of the prostate (HoLEP), even after a successful same-day trial of void (SDTOV).
- Identifying modifiable perioperative risk factors is crucial for improving patient outcomes and reducing healthcare costs associated with unplanned interventions.
Purpose of the Study:
- To identify modifiable perioperative risk factors for delayed urinary retention (DUR) following successful same-day trial of void (SDTOV) in patients undergoing holmium laser enucleation of the prostate (HoLEP).
Main Methods:
- A prospective, single-surgeon HoLEP database was analyzed for patients experiencing DUR post-SDTOV.
- Exclusion criteria included the initial 50 cases, failed SDTOV, and clot retention.
- Unpaired t tests, chi-squared analysis, and multivariate logistic regression were employed to identify significant risk factors (P <.05).
Main Results:
- Of 348 patients undergoing HoLEP, 18 (5.17%) experienced DUR.
- No significant differences were observed in patient demographics, comorbidities, or preoperative factors.
- Intraoperative urethral dilation (25.8% of cases) and postoperative continuous bladder irrigation (7.7% of cases) were significantly associated with DUR.
Conclusions:
- Intraoperative urethral dilation and postoperative continuous bladder irrigation are significant predictors of non-clot related DUR after HoLEP.
- These findings suggest enhanced patient counseling and potential consideration for catheter discharge in cases involving these procedures to minimize morbidity and unplanned healthcare utilization.
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