Holmium laser ablation of the prostate (HoLAP): intermediate-term results of 144 patients
- 216 Downloads
To retrospectively analyse the intermediate-term outcome of holmium laser ablation of the prostate (HoLAP) of up to 4 years postoperatively in one of the largest series and to define the selection criteria for patients who benefit from potentially lower complications associated with HoLAP.
Between June 2006 and November 2010, 144 patients with benign prostatic obstruction were treated at two centres with standardised HoLAP (2.0 J/50 Hz or 3.2 J/25 Hz with Versapulse® 80–100 W laser Lumenis®). Median follow-up was 21 months (range, 1–54). International prostate symptom score and quality of life (IPSS-QoL), PSA, prostate volume, maximal flow rate (Qmax), postvoiding residual volume (Vres) were evaluated pre- and postoperatively. All complications were graded according to CTCAE (v4.03).
Mean patient age was 70.1 ± 7.7 years (range, 46–90). With a preoperative median prostate volume of 40 ml (range, 10–130), the median operation time was 50 min (range, 9–138). We observed a median catheterisation time of 1 day (range, 0–12) and hospitalisation time of 2 days (range, 1–16). IPSS-QoL, Qmax and Vres were significantly improved after 3 months, and all parameters remained unchanged after 12, 24 and 36 months. The rate of re-operation was significantly lower in patients with prostate volume <40 ml, compared to patients with prostates ≥40 ml (9.1 vs. 25 %, p = 0.04).
HoLAP is a safe and effective procedure for the treatment of prostates <40 ml. Patients benefit from HoLAP because of a low bleeding rate and short hospital stay. Due to high recurrence rates, HoLAP should be avoided in prostates >40 ml.
KeywordsBenign prostatic hyperplasia BPH HoLAP Holmium laser Ablation of the prostate
Conflict of interest
The authors certify that there is no actual or potential conflict of interest in relation to this article.
- 12.Oelke M, Burger M, Castro-Diaz D et al (2011) Diagnosis and medical treatment of lower urinary tract symptoms in adult men: applying specialist guidelines in clinical practice. BJU Int. doi: 10.1111/j.1464-410X.2011.10808.x
- 15.Ruszat R, Seitz M, Wyler SF et al (2009) Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia. BJU Int 104:820–825PubMedCrossRefGoogle Scholar