Long-term outcomes of holmium laser enucleation of the prostate: A 5-year single-center experience

Objective: To analyze the long-term efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia. Materials and Methods: A total of 127 patients who underwent HoLEP at our institution between 2013 and 2015 were included. Patients were observed for 5 years postoperatively. We evaluated the length of the surgery, the mass of the removed tissue, prostate-specific antigen level, the maximal flow rate (Qmax), postvoid residual (PVR), the length of catheterization and hospitalization, and the International Prostate Symptom Score (IPSS) and IPSS quality of life (QoL) at each clinic visit. Results: PVR, Qmax, IPSS, and QoL all improved significantly immediately after the operation ( p < 0.001). By the end of the 5th postoperative year, all the parameters showed a statistically meaningful decline: Qmax reduced by 5.8mL/s (22.6%) and IPSS by 1.4 points (29.1%). Around 8.6% of the patients continued therapy with a-blockers. There were no differences in efficacy by the age of the patients or the volume of the prostate. Longterm complications and need for repeat operations were not affected by the volume of the prostate or patient age. Conclusions: The improvement of PVR, Qmax, IPSS, and QoL score seen in the early postoperative period after performing HoLEP remains evident at 5 years postoperatively. Long-term complications and the need for reoperation do not depend on the age of the patient or on the initial volume of the prostate.