WCE 2018: Holmium Laser Enucleation of Prostate and Prostate Cancer Active Surveillance: An Acceptable Therapy for Refractory Lower Urinary Tract Symptoms

Paris, France (UroToday.com) Men with a low or very low risk for prostate cancer that elect for active surveillance may develop lower urinary tract symptoms requiring medical or surgical management. The authors indicated that radical prostatectomy may lead to long term incontinence while overtreating lower risk prostate disease. In this light, the authors sought to present oncologic outcomes for active surveillance of patients with low risk prostate cancer receiving Holmium laser enucleation of the prostate.

Patients with a pre-existing low risk prostate cancer diagnosis who elected for active surveillance were selected for this study. Patients were recruited from 2007-2017 before they received treatment for their lower urinary tract symptoms. All prostate enucleations occurred at the same institution, and a total of 25 patients participated in this analysis.

The authors found that holmium enucleation remains effective in treating lower urinary tract symptoms and shows little risk of long-term complications like incontinence. Over two-thirds of the men in this study remained on active surveillance for twenty or more months following enucleation (Figure 1). 

UroToday WCE2018 Graph detailing Prostate Cancer Treatment Free Survival for this study
Figure 1: Graph detailing Prostate Cancer Treatment Free Survival for this study.

Despite these findings, Dr. Gearman made it clear that more studies with more power will be needed moving forward in order to replicate and solidify the authors' findings.

Presented by: Derek J Gearman MD, 
Co-Authors: Deepak Agarwal MD, Vidit Sharma MD, and Marcelino Rivera MD
Author Affiliation: Mayo Clinic, Rochester, MN USA

Written by: Mitchell O’Leary, Department of Urology, University of California-Irvine) medical writer for UroToday.com at the 36th World Congress of Endourology (WCE) and SWL - September 20-23, 2018 Paris, France
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