Holmium laser enucleation of the prostate: results at 6 years.
OBJECTIVE
The issue of durability is an important concern when evaluating new surgical modalities. To date, only 24-mo data have been published on holmium enucleation of the prostate (HoLEP) despite its widespread use worldwide although 4-yr data exist for the earlier technique of holmium resection. This study addresses the issue of durability of HoLEP.


METHODS
All patients who had undergone HoLEP and been evaluated in three prospective trials conducted at this institution between 1997 and 2002 were evaluated. Patients available at follow-up had data assessed on the International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), quality of life (QOL), International Continence Society Male Short Form (ICS-SF), International Index of Erectile Function (IIEF), Benign Prostatic Hyperplasia Impact Index (BPHII), and continence questionnaire.


RESULTS
The mean follow-up was 6.1 yr (range: 4.1-8.1 yr). The mean age of the patients at follow-up was 75.7 yr (range: 58-88 yr). Of 71 HoLEP patients originally studied on the protocol, 38 (54%) were available for analysis, 14 were deceased, and 19 were lost to follow-up. The mean IPSS for this group was 8.5 (range: 0-24) and Q(max) 19 ml/s (range: 6-28 ml/s). The QOL score was 1.8 (range: 0-5) and the BPHII 2.0 (range: 0-11). One patient (1.4%) had undergone reoperation, an additional HoLEP. Overall, 92% were either satisfied or extremely satisfied with their outcome.


CONCLUSIONS
HoLEP is durable and most patients remain satisfied or extremely satisfied with the long-term outcome.
Gilling
Peter J
PJ
Department of Urology, Tauranga Hospital, Tauranga, New Zealand. peter@promed.co.nz <peter@promed.co.nz>
Aho
Tevita F
TF
Frampton
Christopher M
CM
King
Colleen J
CJ
Fraundorfer
Mark R
MR
D000368:Aged; D000369:Aged, 80 and over; D006695:Holmium; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery*
D006695:Holmium