The efficacy of transurethral holmium laser enucleation of the prostate (HoLEP) in the preservation of the urethral ridge in the treatment of prostatic hyperplasia in patients aged 75 years or less

To evaluate the efficacy of Transurethral holmium laser enucleation of the prostate (HoLEP) with preservation of the urethral ridge in the treatment of benign prostatic hyperplasia (BPH) in patients aged 75 years or less. We conducted retrospective analysis of clinical data acquired from 80 patients aged 75 years or less with BPH. We also included 30 cases of HoLEP with preservation of the “urethral ridge” (the modified group) and 50 cases of HoLEP (the control group). Analysis showed that there were no significant differences in operation time (59.5 (55.0, 66.0) min vs. 57.0 (52.5, 64.3) min), the weight of prostate tissue removed (45.4 ± 13.5 vs. 47.7 ± 15.2 grams), hemoglobin drop (1.5 ± 0.4 grams per liter vs. 1.4 ± 0.3 grams per liter), the time of postoperative bladder irrigation (21.0 (19.8, 23.3) h vs. 21.0 (19.0, 23.2) h), postoperative indwelling catheter time (4.0 (3.0, 4.0) d vs. 4.0 (3.0, 4.0) d) and postoperative hospitalization time (5.0 (4.0, 5.0) d vs. 5.0 (4.0, 5.0) d) between the two groups (all p > 0.05). However, there was a significant difference in the immediate postoperative urinary control rate (93.3% (28/30) vs. 76% (38/50), p < 0.05) and the incidence of retrograde ejaculation (5 cases (16.7%) vs. 19 cases (38%), p < 0.05) between the two groups. In addition, we identified significant differences in the International Prostate Symptom Score (IPSS), quality-of-life score (QoL), maximum urinary flow rate (Qmax), International Index of Erectile Function score (IIEF-5), and postvoid residual volume (PVR) intragroup comparison (all p < 0.05). The efficacy of HoLEP with preservation of the “urethral ridge” in the treatment of BPH was found to be comparable to that of conventional two-lobe HoLEP but can improve the rate of immediate urinary control and reduce the incidence of retrograde ejaculation.

Holmium laser enucleation of the transurethral prostate; Benign prostatic hyperplasia (BPH); Urethral ridge; Immediate urinary control; Retrograde ejaculation

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