You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology1 Apr 20112266 HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP): LONG TERM DURABILITY OF CLINICAL OUTCOMES AND COMPLICATION RATES OVER 10 YEARS FOLLOW UP IN A LARGE PATIENT COHORT Hazem Elmansy, Ahmed Kotb, and Mostafa Elhilali Hazem ElmansyHazem Elmansy Montreal, Canada More articles by this author , Ahmed KotbAhmed Kotb Montreal, Canada More articles by this author , and Mostafa ElhilaliMostafa Elhilali Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2509AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES HoLEP has demonstrated good short- to midterm clinical improvement. However, long-term durability (>5 years) is still lacking. The aim of our study is to assess the long term durability of the subjective and objective outcomes and complication rates. METHODS A retrospective analysis of 952 patients treated with HoLEP between March 1998 and September 2010, in a single center. Study variables included measurement of maximum urinary flow rate (Qmax), post void residual urine (PVR), international prostate symptom score (IPSS) and quality of life (QoL). Follow-up evaluations were done for the patients during their visits over 10 years follow up postoperatively. Complications rates were also recorded. RESULTS The median age of the patients, pre and post operative PSA, prostate volume and operative time were 70 years, 4.3 ng/ml, 0.6 ng/ml, 81 grams and 96 minutes respectively. The mean follow up period was 62 months. The mean preoperative PVR, Qmax, IPSS and Qol were 310 ml, 7.9 ml/sec, 19 and 3.8 respectively. Postoperatively; all the variables showed a significant improvement starting at first month of follow up, and kept significantly low over the whole duration of follow up. At 1 month, 1 year and 10 years follow up, the mean PVR was 48, 31 and 28 c.c, mean Qmax was 22, 24 and 27, mean IPSS was 7, 4 and 3.6 and mean Qol was 1.5, 1 and 1 respectively. Patients with acute urinary retention represent 36% (343 patients) of our cohort. Postoperatively; the mean PVR was 45, 25 and 52, mean Qmax was 21, 24 and 23, mean IPSS was 7.3, 4.4 and 3.8 and mean Qol was 1.6, 1 and 0.7 at 1 m, 1 y and 10 y respectively. Transient urinary stress incontinence was found in 47 men (4.9%) in the first 3 months follow up visit. with only 5 patients (0.5%) still have SUI up to the last follow up visit. Persistent urge incontinence was found in 1% of our cohort. Bladder neck contracture and urethral stricture developed in 0.8% and 1.6% of patients, respectively. The reoperation rate as a result of recurrent obstruction because of residual adenoma was 0.7% of patients. CONCLUSIONS HoLEP represents an effective treatment modality for men with symptomatic benign prostatic hyperplasia, with very low rate of complications over a long duration of follow up. Patients who improve from baseline to early follow-up will maintain improvement at later follow-up. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e908 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hazem Elmansy Montreal, Canada More articles by this author Ahmed Kotb Montreal, Canada More articles by this author Mostafa Elhilali Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...