Holmium laser enucleation of the prostate is associated with durable positive outcomes in patients with urinary symptoms

This study investigated the long-term effectiveness of the Holmium laser enucleation of the prostate (HoLEP) in patients with benign prostate hypertrophy (BPH). Researchers suggested that HoLEP ensures durable effectiveness in these patients.

Benign prostatic hypertrophy (BPH) is an enlargement of the prostate gland. This is responsible for urinary symptoms. For patients with moderate to severe urinary symptoms, surgery is often required. Surgery to remove the prostate (or parts of it) was the standard treatment procedure. However, with laser technology, HoLEP gradually replaced conventional surgery.

HoLEP is a minimally invasive method that uses a laser to remove prostate tissue. This tissue is usually blocking the urine flow causing urinary symptoms. Prior studies showed that HoLEP is associated with improved early and mid-term outcomes for symptoms and the need for another surgery. However, long-term outcomes are still not clear.

This study included 125 patients with BPH and urinary symptoms who underwent HoLEP. These patients were followed-up for 10 years.

32 patients (26%) were symptomatic at long-term follow-up. 7 patients (5.7%) reported urinary incontinence (urine leakage), and 6 (4.7%) underwent another surgery.

Older patients (aged over 75 years) at the time of surgery were 1.12 times more at risk of having symptoms after 10-years. Patients who never fully recovered from incontinence had a 51% increase in the odds of having symptoms after 10 years.   

This study concluded that HoLEP ensures a durable decrease of urinary symptoms in most patients after 10 years.

This study was based on information from medical records. Data may have been missing. Further studies are needed.