Transurethral holmium laser enucleation of prostates (HoLEP) larger than 80 grams

In this prospective study, the efficiency of HoLEP in patients with prostates larger than 80 grams was to be evaluated. 64 urodynamically obstructed patients with prostate glands of 103 (80-230) grams of weight underwent HoLEP (80 W., 2.0 J., 40 Hz., 550 nm bare laser fibers). The resected weight was 70 (50-200) grams, the resection time was 120.5 (83-170) min., the average resection weight was 0.7 gm./min. The postoperative catheter time was 1.3 (1-3) days. The postoperative hospital stay was 2.5 (1-7) days, HoLEP induced a significant, pronounced and immediate improvement of lower urinary tract symptoms and micturition. The symptom score decreased from 22.3 preoperatively to 5.7 one week and 2.8 one year postoperatively. The peak urinary flow rate of 4.3 ml./sec. preoperatively increased to 22 ml./sec. one week and 32 ml./sec. one year postoperatively. The residual urine dropped from 267 ml preoperatively to 11.5 ml one week and 5.0 ml one year postoperatively. There was one incident of postoperative arterial bleeding, one patient developed urethral stricture and two patients needed a second HoLEP. HoLEP appeared to be a highly effective treatment for prostates larger than 80 grams, with excellent functional results, minor blood loss, tow complication rate and very short catheter time and hospital stay.