Holmium Laser Resection of the Prostate

Abstract

Objective: This review of holmium laser resection of the prostate (HoLRP) summarises the evolution, points of technique, results of clinical trials and ongoing research concerning this procedure. Methods: Over 3 years of experience with holmium resection/enucleation in two institutions is reviewed. Several open studies and 2 randomised trials are presented and the results discussed. Current work with holmium enucleation of the prostate (HoLEP) in combination with intracavitary morcellation is also reported. Results: HoLRP results in fewer blood transfusions, less nursing contact time, less requirement for bladder irrigation, and a shorter catheter time and hospital stay than for patients treated with standard electrocautery resection of the prostate (TURP). Preliminary results suggest equivalent symptomatic relief, and relief of bladder outflow obstruction between the two procedures. Conclusions: Holmium prostatectomy continues to evolve. Preliminary experience suggests that it may be a viable alternative to TURP and appears to have some significant advantages. Newer techniques for tissue retrieval may significantly decrease the operating time.