title: Holmium laser enucleation of the prostate: surgical, functional, and quality-of-life outcomes upon extended follow-up.
abstract: OBJECTIVE
  To evaluate the long-term surgical, functional, and quality-of-life (QoL) outcomes after Holmium laser enucleation of the prostate (HoLEP) in patients with symptomatic benign prostatic hyperplasia (BPH).
  
  
  METHODS
  We retrospectively reviewed recorded data on patients who underwent HoLEP between June 2002 and February 2005. Ninety-six patients were enrolled. Demographic, perioperative, and postoperative data were recorded. On follow-up, International Prostate Symptom Scores (IPSSs), prostate-specific antigen (PSA) levels, QoL scores, peak uroflowmetric data (Qmax values), and post-voiding residual urine volumes (PVR volumes), were recorded. Complications were scored using the Clavien system. Statistical significance was set at p<0.05.
  
  
  RESULTS
  The mean follow-up time was 41.8±34.6 months and the mean patient age 73.2±8.7 years. The mean prostate volume was 74.6±34.3mL. Significant improvements in Qmax values, QoL, and IPSSs and decreases in PSA levels and PVR volumes were noted during follow-up (all p values=0.001). The most common complication was a requirement for re-catheterisation because of urinary retention. Two patients had concomitant bladder tumours that did not invade the muscles. Eight patients (8.3%) required re-operations; three had residual adenoma, three urethral strictures, and two residual prostate tissue in the bladder. Stress incontinence occurred in one patient (1%). All complications were of Clavien Grade 3a. We noted no Clavien 3b, 4, or 5 complications during follow-up.
  
  
  CONCLUSIONS
  HoLEP improved IPSSs, Qmax values, PVR volumes, and QoL and was associated with a low complication rate, during extended follow-up. Thus, HoLEP can be a viable option to transurethral resection of the prostate.
authors.affiliation: Department of Urology, Okmeydani Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: Ilter
authors.initials: I
authors.lastname: Alkan
authors.affiliation: Department of Urology, Acibadem University School of Medicine, Kozyatagi, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozveri
authors.affiliation: Deparment of Urology, Harran University School of Medicine, Sanliurfa, Turkey.
authors.forename: Yigit
authors.initials: Y
authors.lastname: Akin
authors.affiliation: Department of Urology, Baskent University School of Medicine, Alanya Teaching and Research Hospital, Alanya, Antalya, Turkey.
authors.forename: Tumay
authors.initials: T
authors.lastname: Ipekci
authors.affiliation: Department of Urology, Prosmed Clinic, Nisantasi, Istanbul, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Alican
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications; D011467:Prostate / Q000473:pathology / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery
chemical_list: D017430:Prostate-Specific Antigen