Objectives: To evaluate the safety and efficacy of holmium laser enucleation of the prostate in patients with small to moderate size prostate.
Methods: We retrospectively reviewed the data of 224 patients with a preoperative prostate size </=60 cm(3), who had undergone holmium laser enucleation of the prostate at our institution from March 1998 to February 2005. The patient characteristics, indications for surgery, preoperative and postoperative International Prostate Symptom Score, including quality-of-life score, peak urinary flow rate, postvoid residual urine volume, enucleation time, morcellation time, total energy used, enucleated tissue weight, catheterization time, hospital stay, pathologic examination findings, and complications were recorded.
Results: The mean prostate size was 43 +/- 11.1 cm(3), the mean operative time was 80 minutes, and the enucleated tissue weight was 24 g. The mean catheterization time and hospital stay was 1.2 and 1.4 days, respectively. No major intraoperative complications were encountered. Only 2 patients (0.9%), who were receiving anticoagulation therapy, required a postoperative blood transfusion. At 1 year postoperatively, the International Prostate Symptom Score had improved from 17.6 +/- 6.7 to 4.9 +/- 4.4 (72%), the quality-of-life score had improved from 3.5 +/- 1.3 to 1.2 +/- 1.3 (66%), the peak urinary flow rate had increased from 7.5 +/- 3.1 to 21.2 +/- 9.5 mL/s (183%), and the postvoid residual urine volume had decreased from 155 +/- 170 to 27 +/- 48 mL (83%).
Conclusions: Holmium laser enucleation of the prostate is safe and effective treatment in patients with small to moderate size prostate as well as those with larger prostates, with low morbidity and a short catheterization time and hospital stay.