Examining infection rates after HoLEP: a minimally invasive procedure for BPH

BPH can lead to bothersome urinary symptoms and surgery is often required to remove the enlarged prostate tissue. Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure to treat BPH. HoLEP allows for the destruction of prostate tissue with a laser inserted into the urethra (the penile opening). HoLEP is generally well-tolerated and associated with relatively few complications. However, more studies are needed to examine the rate of infection after HoLEP. An infection can occur during or after a surgical procedure when bacteria enter body tissue.

The aim of this study was to examine the incidence of infection after HoLEP.

The records of 190 men with BPH were analyzed. All men were treated with HoLEP. 78 men had bacteria present in the urine before the procedure. The remaining 112 men were negative for bacteria in the urine before treatment. All men received treatment with antibiotics (that kill bacteria) from the day of the procedure for 3 days to prevent infection.

The overall rate of bacterial infection 3 days after HoLEP was 25%.

Of the 112 men negative for bacteria before treatment, 8 men had bacteria in the urine after HoLEP. 41 men remained negative after HoLEP. No information on bacteria in the urine was available for the remaining 63 patients.

Of the 78 men positive for bacteria in their urine before HoLEP, 17 men remained positive after the procedure. 33 men were negative for bacteria. No information was available for the remaining 28 patients.

Men taking dutasteride (Avodart) before the procedure for BPH-related urinary symptoms were significantly less likely to have bacteria present in the urine after HoLEP. The most common strain of bacteria found in the urine both before and after the procedure was Enterococcus faecalis (commonly found in the intestine).

Authors concluded that the use of antibiotics kept the rates of infection low after HoLEP. Dutasteride administered before the procedure may reduce the risk of infection.

Larger studies are needed to confirm these results.