HoLEP for urinary retention: how effective is it?
BAUS ePoster online library. Georgiades F. 06/21/21; 319073; p3-5
Disclosure(s): Tev Aho has received honoraria from Lumenis Ltd and Boston Scientific Corporation
Fanourios Georgiades
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Abstract
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Introduction
No comparisons of catheter-free rates after holmium laser enucleation of the prostate (HoLEP) for acute vs non-neurogenic chronic urinary retention (AUR and NNCUR) have been published previously. It is unclear whether long-term surveillance is indicated after HoLEP for high pressure chronic urinary retention (HPCUR) to monitor for deterioration in renal function.
Patients and Methods
A prospectively maintained database of the first 500 consecutive HoLEP cases performed under the care of a single surgeon was analysed retrospectively. Urodynamic studies did not play a role in the decision making process for those with AUR or NNCUR. NNCUR was defined as painless with PVR>300ml in those who could void and initial catheter drainage >1,000ml in those who could not void.
Results
280/500 (56%) were in UR: AUR in 195 and NNCUR in 85, including 22 with HPCUR. Although only 58.8% with NNCUR passed first TWOC vs 84.6% with AUR, 98.8% vs 98.9% respectively were catheter-free at 3 months. No patient with HPCUR had clinically significant deterioration in serum creatinine after HoLEP for HPCUR at median follow-up of 60 months.
Conclusions
HoLEP has 3-month catheter-free rates > 98.5% for both AUR and NNCUR in patients not pre-selected by UDS. Those with AUR are more likely to pass first TWOC than those with NNCUR. HoLEP is a durable treatment for HPCUR and we found no evidence of recurrent HPCUR in the long term.
No comparisons of catheter-free rates after holmium laser enucleation of the prostate (HoLEP) for acute vs non-neurogenic chronic urinary retention (AUR and NNCUR) have been published previously. It is unclear whether long-term surveillance is indicated after HoLEP for high pressure chronic urinary retention (HPCUR) to monitor for deterioration in renal function.
Patients and Methods
A prospectively maintained database of the first 500 consecutive HoLEP cases performed under the care of a single surgeon was analysed retrospectively. Urodynamic studies did not play a role in the decision making process for those with AUR or NNCUR. NNCUR was defined as painless with PVR>300ml in those who could void and initial catheter drainage >1,000ml in those who could not void.
Results
280/500 (56%) were in UR: AUR in 195 and NNCUR in 85, including 22 with HPCUR. Although only 58.8% with NNCUR passed first TWOC vs 84.6% with AUR, 98.8% vs 98.9% respectively were catheter-free at 3 months. No patient with HPCUR had clinically significant deterioration in serum creatinine after HoLEP for HPCUR at median follow-up of 60 months.
Conclusions
HoLEP has 3-month catheter-free rates > 98.5% for both AUR and NNCUR in patients not pre-selected by UDS. Those with AUR are more likely to pass first TWOC than those with NNCUR. HoLEP is a durable treatment for HPCUR and we found no evidence of recurrent HPCUR in the long term.
Introduction
No comparisons of catheter-free rates after holmium laser enucleation of the prostate (HoLEP) for acute vs non-neurogenic chronic urinary retention (AUR and NNCUR) have been published previously. It is unclear whether long-term surveillance is indicated after HoLEP for high pressure chronic urinary retention (HPCUR) to monitor for deterioration in renal function.
Patients and Methods
A prospectively maintained database of the first 500 consecutive HoLEP cases performed under the care of a single surgeon was analysed retrospectively. Urodynamic studies did not play a role in the decision making process for those with AUR or NNCUR. NNCUR was defined as painless with PVR>300ml in those who could void and initial catheter drainage >1,000ml in those who could not void.
Results
280/500 (56%) were in UR: AUR in 195 and NNCUR in 85, including 22 with HPCUR. Although only 58.8% with NNCUR passed first TWOC vs 84.6% with AUR, 98.8% vs 98.9% respectively were catheter-free at 3 months. No patient with HPCUR had clinically significant deterioration in serum creatinine after HoLEP for HPCUR at median follow-up of 60 months.
Conclusions
HoLEP has 3-month catheter-free rates > 98.5% for both AUR and NNCUR in patients not pre-selected by UDS. Those with AUR are more likely to pass first TWOC than those with NNCUR. HoLEP is a durable treatment for HPCUR and we found no evidence of recurrent HPCUR in the long term.
No comparisons of catheter-free rates after holmium laser enucleation of the prostate (HoLEP) for acute vs non-neurogenic chronic urinary retention (AUR and NNCUR) have been published previously. It is unclear whether long-term surveillance is indicated after HoLEP for high pressure chronic urinary retention (HPCUR) to monitor for deterioration in renal function.
Patients and Methods
A prospectively maintained database of the first 500 consecutive HoLEP cases performed under the care of a single surgeon was analysed retrospectively. Urodynamic studies did not play a role in the decision making process for those with AUR or NNCUR. NNCUR was defined as painless with PVR>300ml in those who could void and initial catheter drainage >1,000ml in those who could not void.
Results
280/500 (56%) were in UR: AUR in 195 and NNCUR in 85, including 22 with HPCUR. Although only 58.8% with NNCUR passed first TWOC vs 84.6% with AUR, 98.8% vs 98.9% respectively were catheter-free at 3 months. No patient with HPCUR had clinically significant deterioration in serum creatinine after HoLEP for HPCUR at median follow-up of 60 months.
Conclusions
HoLEP has 3-month catheter-free rates > 98.5% for both AUR and NNCUR in patients not pre-selected by UDS. Those with AUR are more likely to pass first TWOC than those with NNCUR. HoLEP is a durable treatment for HPCUR and we found no evidence of recurrent HPCUR in the long term.
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