Laser treatment of benign prostatic hyperplasia after failed UroLift

This study aimed to investigate the surgical treatment of benign prostatic hyperplasia (BPH) using Holmium laser enucleation of the prostate (HOLEP) after failed UroLift. This study showed that HOLEP can be safely used after UroLift.

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. BPH can impede the flow of urine. This leads to lower urinary tract symptoms (LUTS) such as dribbling of urine and a feeling of incomplete bladder emptying. The prostatic urethral pull (UroLift) procedure works by separating the enlarged prostate lobes to make the urethra wider so that it is easier to urinate. Implants are left in the prostate. Retreatment rates following UroLift have been reported at 13.6% over 5 years. Holmium laser enucleation (HLE) is another procedure used in BPH. This procedure uses a laser to remove prostate tissue that is blocking urine flow.

It is not known if HLE can be safely used after a UroLift failure.

This study included 118 patients who had HLE. 3 of those patients had previously had UroLift. 

Throughout the surgeries, implant clips must be removed using a morcellator. In 2 of the 3 patients who had UroLift, the morcellator jammed. However, 3 months after the surgery, no implant material was identified in either of the surgeries.

This study showed that HOLEP can be safely used after UroLift in patients with BPH.

This study was done in only one institution, with procedures done by one surgeon. Different results may be obtained by different surgeons. More investigation is needed.