title: Holmium laser enucleation of the prostate is safe in patients with prostate cancer and lower urinary tract symptoms--a retrospective feasibility study.
abstract: OBJECTIVE
  To evaluate the outcome of holmium laser enucleation of the prostate (HoLEP) in the known presence of prostate cancer (PCa) and concomitant lower urinary tract symptoms (LUTS).
  
  
  METHODS
  We retrospectively identified 62 patients who underwent HoLEP for LUTS in the known presence of PCa at our center. Perioperative data were assessed including complications, functional outcomes, and quality of life (QoL). Giving respect to different disease characteristics, patients were stratified according to treatment strategy setting into palliative (I), radiation (II), and surveillance (III) groups and compared accordingly.
  
  
  RESULTS
  Median follow-up (FU) of the entire study cohort was 27 months (range 2-65 mos). Medians of functional parameters (International Prostate Symptom Score): 18.5 vs 4.5, QoL: 4 vs 1, maximal flow rate: 9.0 vs 18.8 mL/s and residual urine: 100 vs 0 mL, all P<0.05) improved significantly in all groups. Perioperative complications were low and without any statistically significant difference between the groups. Postoperatively, voiding was successful in 90.3% of all patients; at last FU, 17% had some degree of urinary incontinence. Treatment strategy groups showed comparable functional outcomes after HoLEP.
  
  
  CONCLUSIONS
  In the presence of PCa and LUTS, HoLEP represents a feasible, safe, and effective treatment option for patients unfit or without indication for radical prostatectomy. This applies as well in a palliative situation of advanced, obstructive PCa as for patients with LUTS who are scheduled for radiation therapy or surveillance in presumably indolent disease.
authors.affiliation: 1 Department of Urology, University Medical Centre Hamburg-Eppendorf , Hamburg, Germany .
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
authors.forename: Anne
authors.initials: A
authors.lastname: Placke
authors.forename: Luis
authors.initials: L
authors.lastname: Kluth
authors.forename: Rudolf
authors.initials: R
authors.lastname: Schwarz
authors.forename: Hendrik
authors.initials: H
authors.lastname: Isbarn
authors.forename: Felix
authors.initials: F
authors.lastname: Chun
authors.forename: Roman
authors.initials: R
authors.lastname: Heuer
authors.forename: Thorsten
authors.initials: T
authors.lastname: Schlomm
authors.forename: Daniel
authors.initials: D
authors.lastname: Seiler
authors.forename: Oliver
authors.initials: O
authors.lastname: Engel
authors.forename: Margit
authors.initials: M
authors.lastname: Fisch
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Sascha A
authors.initials: SA
authors.lastname: Ahyai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D059411:Lower Urinary Tract Symptoms / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D014554:Urination