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Updated: Aug 5, 2026
Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).
Published on: March 6, 2018
Immediate urinary continence after continence-preserving holmium laser enucleation versus transurethral plasmakinetic
Dihao Lv1, Chen Gong1, Zhiyong Tan1
1Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Yunnan Institute of Urology, Kunming, 650101, Yunnan, China.
Purpose:
To compare immediate postoperative urinary continence and short-term functional outcomes between continence-preserving holmium laser enucleation of the prostate (HoLEP) and transurethral plasmakinetic prostatectomy (TUPKP) in patients with benign prostatic hyperplasia (BPH).
Methods:
We retrospectively analyzed 212 consecutive men who underwent continence-preserving transurethral surgery for BPH at a single center between October 2024 and November 2025. Patients were grouped according to the procedure actually received (HoLEP, n = 109; TUPKP, n = 103). The primary endpoint was immediate continence after catheter removal, defined as < 1 g leakage on a standardized 1-h pad test. Pad weight was analyzed with non-parametric testing because of skewness. Multivariable logistic regression and propensity-score sensitivity analyses were used to adjust the comparison of immediate continence.
Results:
Baseline characteristics were generally balanced between groups. Immediate continence was achieved in 74/109 patients after HoLEP and 33/103 patients after TUPKP (67.89% vs. 32.04%, P < 0.001). The association remained significant after multivariable adjustment (adjusted odds ratio [OR] 9.99, 95% CI 4.56-21.86, P < 0.001) and in a propensity-score weighted sensitivity model (OR 5.06, 95% CI 2.82-9.06, P < 0.001). Median 1-h pad weight was lower after HoLEP (0.74 g [IQR 0.51-1.49]) than after TUPKP (3.58 g [IQR 0.88-6.79], P < 0.001). At 1 month, HoLEP was associated with lower IPSS and better QoL, while Qmax was similar between groups. Bladder irrigation time, catheterization time, and postoperative hospital stay were shorter after HoLEP. A significant procedure-by-prostate-volume interaction suggested that the association between gland size and early leakage was weaker after HoLEP than after TUPKP.
Conclusion:
Continence-preserving HoLEP was associated with higher immediate urinary continence and faster early postoperative recovery than continence-preserving TUPKP, while achieving similar short-term flow improvement. These findings should be interpreted as early functional outcomes from a single-center retrospective cohort; longer prospective follow-up is needed to confirm durable continence and complication profiles.
