[Complications of the holmium laser enucleation of prostate for benign prostatic hyperplasia]

With growing experience in the HoLEP, it can replace TURP as the "gold standard" for the surgical management of BPH, and therefore this technique is the most studied surgical modality. Despite the proven effectiveness of HoLEP in the treatment of patients with BPH, its widespread use has been associated with both intra- and postoperative complications.

To improve the results of surgical management of patients with BPH.

The study comprised 310 patients who underwent HoLEP for BPH. HoLEP was performed using the Gillings technique.

presence of LUTS (Qmax<15 ml/s, Qav<10 ml/s, presence of residual urine, I-PSS score> 5, QoL score> 2), absence of an active inflammatory process of the urogenital organs.

Intraoperative complications included severe hemorrhage in 16 (5.2%), the bladder wall injury in 17 (5.5%) and the ureteral orifice injury in 2 (0.6%) patients. 275 (88.7%) had no intraoperative complications. Early postoperative complications included fever in 4 (1.3%), the bladder tamponade that required cystoscopy and evacuation of blood clots in 7 (2.3%) and acute urinary retention in 36 (11.8%) patients. 263 (84.6%) patients had no postoperative complications. Long-term postoperative complications comprised urinary incontinence in 39 (12.6%) patients and urethral strictures requiring surgical treatment in 9 (2.9%) patients. There were no long-term complications in 262 (84.5%) patients.

HoLEP is an effective and safe surgical modality for treating patients with BPH with minimal complications, suitable for any size of the prostate.

Urologiia (Moscow, Russia : 1999). 2018 Mar [Epub]

D S Davydov, D G Tsarichenko, E A Bezrukov, R B Sukhanov, A Z Vinarov, N I Sorokin, D V Enikeev, A M Dymov, S P Danilov

Research Institute for Uronephrology and Human Reproductive Health, Department of Urology, R.M. Fronshteyn Urology Clinic, I.M. Sechenov First MSMU of Minzdrav of Russia, Moscow, Russia.