Table 1.
HoLEP outcomes based on prostate size
| Study | Prostate size (N) | Efficacy | Complications |
|---|---|---|---|
| Lee et al7 | <40 g (15) 40–80 g (15) >80 g (15) |
• No differences between HoLEP vs TURP • Outcomes of HoLEP stratified by prostate size not compared |
• No difference in TUI for HoLEP vs TURP • Outcomes of HoLEP stratified by prostate size not compared |
| Krambeck et al8 | >175 g (57) | • Significant improvement at 6 months FU • AUASS 6.5 from 19.0 preop • Qmax 18.6 mL/s from 8.2 mL/s preop |
• Blood transfusion (2), clot evacuation (1) • No one with persistent incontinence |
| Humphreys et al9 | <75 g (164) 75–125 g (226) >125 g (117) |
• Similar postop catheterization, AUASS, Qmax, and PSA | • Similar complication rates between the three groups |
| Shah et al10 | <60 g (235) 60–100 g (77) >100 g (42) |
• No difference at 1-y FU | • ⇧ Meatal stenosis (7.1 vs 1.3%–2.6%) if >100 g • ⇧ Urethral stricture (4.8 vs 1.3%–2.6%) if >100 g |
| Kuntz et al11,14 | >100 g (60 – in initial study, 42 – 5-y FU) |
• Compared to open SPP (60 per arm) • Similar resected tissue (94 vs 96 g) • HoLEP had shorter LOS, less blood loss, shorter catheterization time, but longer operative time (135 vs 90 min) |
• 13% open SPP required blood transfusion vs 0% in the HoLEP arm (P=0.003) • Three in each arm required cystoscopy and fulguration postop |
| 5-y FU • No difference vs open SPP at 5-y FU • AUASS 3.0 from 22.1 preop • Qmax 24.3 mL/s from 3.8 mL/s preop • PVR 10.6 mL from 280 mL |
5-y FU • No difference vs open SPP • Urethral stricture (2), BNC (1) |
||
| Seki et al12 | <50 g (59) ≥ 50–99 g (27) ≥ 100 g (11) |
• No difference at 6 months FU | • No difference |
| Matlaga et al13 | >125 g (86) | • Significant improvement at 12 months FU • AUASS 5.1 from 19.6 preop • Qmax 24.9 mL/s from 9.1 mL/s preop |
• Sepsis (1), clot evacuation (1), blood transfusion (1), myocardial infarction (1) • Long-term postop complications not discussed |
Note: The numbers in parentheses are the number of patients in the series who experienced the complication.
Abbreviations: N, number; FU, follow-up; AUASS, AUA symptom score; Qmax, peak urinary flow rate; preop, preoperatively; postop, postoperatively; SPP, simple suprapubic prostatectomy; y, year; TUI, transient urinary incontinence; PVR, postvoid residual; PSA, prostate-specific antigen; HoLEP, holmium laser enucleation of the prostate; TURP, transurethral resection of the prostate; LOS, length of stay; BNC, bladder neck contracture; min, minutes.