MP29-02 SALVAGE VERSUS PRIMARY HOLMIUM LASER ENUCLEATION FOR BPH: AN OUTCOMES AND SAFETY ANALYSIS

Abstract

You have accessJournal of UrologyCME1 May 2022MP29-02 SALVAGE VERSUS PRIMARY HOLMIUM LASER ENUCLEATION FOR BPH: AN OUTCOMES AND SAFETY ANALYSIS Adri Durant, Sandeep Voleti, Sarah Wu, Jonathan Moore, Gopal Narang, Scott Cheney, and Mitchell Humphreys Adri DurantAdri Durant More articles by this author , Sandeep VoletiSandeep Voleti More articles by this author , Sarah WuSarah Wu More articles by this author , Jonathan MooreJonathan Moore More articles by this author , Gopal NarangGopal Narang More articles by this author , Scott CheneyScott Cheney More articles by this author , and Mitchell HumphreysMitchell Humphreys More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002572.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Repeat surgical treatment for benign prostatic hyperplasia (BPH) is not uncommon. Minimally invasive surgical therapies (MIST) and transurethral resection of the prostate (TURP) have known retreatment rates ranging from 5% to 13% at 5 years. Holmium laser enucleation of the prostate (HoLEP) is an effective primary treatment for BPH but also as can be utilized as a salvage modality. This study assesses the safety and efficacy of salvage HoLEP (s-HoLEP) after prior BPH surgery. METHODS: A retrospective review of HoLEP at a single institution between 2006 and 2020 was performed. Patients who had a s-HoLEP were evaluated and compared to those undergoing a primary HoLEP (p-HoLEP). Out of a total of 1960 HoLEPs, 217 were s-HoLEP and these were matched 2:1 to 416 p-HoLEPs to compare preoperative, operative and post-operative characteristics. The primary endpoint was Clavien complications within 90 days of surgery. Secondary endpoints included quantitative measurements of lower urinary tract symptoms (LUTS), International Prostate Symptoms Score (IPSS), maximum urinary flow (Qmax) and postvoid residual volumes (PVR). Kruskal-Wallis rank sum test was used for analysis of continuous variables and Fischer’s exact test was used for categorical variables. RESULTS: The s-HoLEP cohort was older, median age of 71.2 years, compared to p-HoLEP at 68.8 years (p = 0.03). All other factors were well matched. Pre-operative prostate volume, IPSS and Qmax were not different (p = 0.783, 0.278, and 0.759, respectively). However, rates of pre-op urinary retention and PVRs were higher in the p-HOLEP group (p = <0.001 and 0.045, respectively). Intra-operatively, the s-HOLEP cohort had longer procedure and morcellation times (p = 0.011 and 0.007). Post-operatively, the s-HOLEP required longer catheter duration and hospitalization (both p < 0.001). There was no difference in Qmax, IPSS or 90-day complication rates (p = 0.108, 0.247, and 0.506, respectively). CONCLUSIONS: S-HoLEP is a safe treatment option for patients requiring repeat BPH surgical therapy. S-HoLEP patients had longer operative times and hospital stay but equivalent long-term efficacy compared to p-HoLEP. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e469 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adri Durant More articles by this author Sandeep Voleti More articles by this author Sarah Wu More articles by this author Jonathan Moore More articles by this author Gopal Narang More articles by this author Scott Cheney More articles by this author Mitchell Humphreys More articles by this author Expand All Advertisement PDF DownloadLoading ...