Holmium laser enucleation of the prostate for persistent lower urinary tract symptoms after prior benign prostatic hyperplasia surgery

Christopher D. Jaeger, Amy Krambeck

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To evaluate comparative safety and outcomes in patients undergoing holmium laser enucleation of the prostate (HoLEP) with and without previous transurethral prostate surgery. Methods: We identified 37 patients who underwent HoLEP for persistent lower urinary tract symptoms (LUTS) after previous transurethral prostate surgery for benign prostatic hyperplasia (group I). Patients were then matched according to preoperative transrectal ultrasound prostate size to 74 patients without prior surgery who underwent HoLEP (group II). A retrospective chart review was performed. Results: In group I, no patients had previously undergone HoLEP, and 9 (24%) had undergone >1 surgery for benign prostatic hyperplasia (BPH). There were no significant differences in age, preoperative mean urinary flow, or preoperative prostate-specific antigen (PSA) value between groups I and II. There were no significant differences in perioperative parameters, including resected tissue weight (61.7 vs 63.9 grams, P =.83) or enucleation rate (1.32 vs 1.36 g/min, P =.76). There was no significant difference in mean catheterization time or length of hospital stay. Postoperative peak flow (23.4 vs 26.9 mL/sec, P =.14) and post-void residual (PVR, 50.9 vs 50.3 mL, P =.61) were improved and similar between groups. American Urological Association Symptom Indices (AUASIs) were improved in both groups, although the primary group was significantly lower (7.52 vs 5.21, P =.0060). There was no significant difference in adverse events. All patients were urinating at last follow-up (mean 18.4 and 15.1 months, P =.16). Conclusion: HoLEP is safe and effective at relieving persistent LUTS after failed previous BPH surgery. Outcomes similar to those of a primary HoLEP procedure can be expected.

Original languageEnglish (US)
Pages (from-to)1025-1029
Number of pages5
JournalUrology
Volume81
Issue number5
DOIs
StatePublished - May 2013
Externally publishedYes

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Lower Urinary Tract Symptoms
Solid-State Lasers
Prostatic Hyperplasia
Prostate
Length of Stay
Prostate-Specific Antigen
Catheterization
Safety
Weights and Measures

ASJC Scopus subject areas

  • Urology

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Holmium laser enucleation of the prostate for persistent lower urinary tract symptoms after prior benign prostatic hyperplasia surgery. / Jaeger, Christopher D.; Krambeck, Amy.

In: Urology, Vol. 81, No. 5, 05.2013, p. 1025-1029.

Research output: Contribution to journalArticle

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abstract = "Objective: To evaluate comparative safety and outcomes in patients undergoing holmium laser enucleation of the prostate (HoLEP) with and without previous transurethral prostate surgery. Methods: We identified 37 patients who underwent HoLEP for persistent lower urinary tract symptoms (LUTS) after previous transurethral prostate surgery for benign prostatic hyperplasia (group I). Patients were then matched according to preoperative transrectal ultrasound prostate size to 74 patients without prior surgery who underwent HoLEP (group II). A retrospective chart review was performed. Results: In group I, no patients had previously undergone HoLEP, and 9 (24{\%}) had undergone >1 surgery for benign prostatic hyperplasia (BPH). There were no significant differences in age, preoperative mean urinary flow, or preoperative prostate-specific antigen (PSA) value between groups I and II. There were no significant differences in perioperative parameters, including resected tissue weight (61.7 vs 63.9 grams, P =.83) or enucleation rate (1.32 vs 1.36 g/min, P =.76). There was no significant difference in mean catheterization time or length of hospital stay. Postoperative peak flow (23.4 vs 26.9 mL/sec, P =.14) and post-void residual (PVR, 50.9 vs 50.3 mL, P =.61) were improved and similar between groups. American Urological Association Symptom Indices (AUASIs) were improved in both groups, although the primary group was significantly lower (7.52 vs 5.21, P =.0060). There was no significant difference in adverse events. All patients were urinating at last follow-up (mean 18.4 and 15.1 months, P =.16). Conclusion: HoLEP is safe and effective at relieving persistent LUTS after failed previous BPH surgery. Outcomes similar to those of a primary HoLEP procedure can be expected.",
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AB - Objective: To evaluate comparative safety and outcomes in patients undergoing holmium laser enucleation of the prostate (HoLEP) with and without previous transurethral prostate surgery. Methods: We identified 37 patients who underwent HoLEP for persistent lower urinary tract symptoms (LUTS) after previous transurethral prostate surgery for benign prostatic hyperplasia (group I). Patients were then matched according to preoperative transrectal ultrasound prostate size to 74 patients without prior surgery who underwent HoLEP (group II). A retrospective chart review was performed. Results: In group I, no patients had previously undergone HoLEP, and 9 (24%) had undergone >1 surgery for benign prostatic hyperplasia (BPH). There were no significant differences in age, preoperative mean urinary flow, or preoperative prostate-specific antigen (PSA) value between groups I and II. There were no significant differences in perioperative parameters, including resected tissue weight (61.7 vs 63.9 grams, P =.83) or enucleation rate (1.32 vs 1.36 g/min, P =.76). There was no significant difference in mean catheterization time or length of hospital stay. Postoperative peak flow (23.4 vs 26.9 mL/sec, P =.14) and post-void residual (PVR, 50.9 vs 50.3 mL, P =.61) were improved and similar between groups. American Urological Association Symptom Indices (AUASIs) were improved in both groups, although the primary group was significantly lower (7.52 vs 5.21, P =.0060). There was no significant difference in adverse events. All patients were urinating at last follow-up (mean 18.4 and 15.1 months, P =.16). Conclusion: HoLEP is safe and effective at relieving persistent LUTS after failed previous BPH surgery. Outcomes similar to those of a primary HoLEP procedure can be expected.

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