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Day-case HOLEP: How to optimize outcomes? Insights from 10 years of clinical experience

Xavier Lacroix1, Clément Klein1, Gaelle Margue1

  • 1Urology Department, CHU Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France.

The French Journal of Urology
|May 3, 2026
PubMed

Insights

Day-case Holmium laser enucleation of the prostate (HoLEP) is safe and effective for benign prostatic hyperplasia (BPH). Larger prostates (>90g) are the primary predictor of day-case HoLEP failure.

Area of Science:

  • Urology
  • Minimally Invasive Surgery

Background:

  • Holmium laser enucleation of the prostate (HoLEP) is a recommended surgical treatment for benign prostatic hyperplasia (BPH).
  • Day-case HoLEP optimizes patient care and reduces healthcare costs.
  • Our team pioneered day-case HoLEP in 2012.

Purpose of the Study:

  • To evaluate the long-term outcomes of day-case HoLEP.
  • To identify predictors of day-case HoLEP failure.

Main Methods:

  • Retrospective analysis of 721 consecutive day-case HoLEP procedures (Jan 2013-Apr 2024).
  • Day-case success defined as discharge within 12 hours and no readmission within 48 hours.
  • Patients divided into three chronological groups; uni- and multivariate analyses performed.

Main Results:

  • 86.6% discharged within 12 hours; 84.1% had no 48-hour readmission.
  • Hematuria requiring irrigation was the main cause of discharge failure.
  • Prostate volume >90g was the sole independent predictor of failure (OR=1.9, p=0.015).

Conclusions:

  • Day-case HoLEP is a safe and feasible surgical option for BPH.
  • It does not increase patient risk and can be integrated into routine practice.
  • Prostate volume >90g is the only significant predictor of failure.
Abstract

Keywords:
AmbulatoireBenign prostatic hyperplasiaDay-case surgeryHolmiumHypertrophie bénigne de prostateLaserLaser surgery

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