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Holmium laser enucleation of the prostate in Jehovah’s Witness patients

  • Urology - Original Paper
  • Published:
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Abstract

Purpose

To evaluate if HoLEP is a viable option for male patients with medication-refractory urinary symptoms due to an enlarged prostate who are surgical candidates, but do not accept blood product transfusion.

Materials and methods

Between August 2008 and March 2019, nine Jehovah’s Witness patients were undergoing HoLEP for relief of lower urinary tract symptoms and urinary retention. We described change in hemoglobin, change in PSA, enucleated prostate weight, enucleation and morcellation times, length of stay, and postoperative retention rate.

Results

The average age was 71.4 years (range 53–87). Urinary retention requiring catheterization was present in seven patients (78%). Two patients had a known diagnosis of prostate cancer preoperatively. The mean preoperative PSA on average was 21.6 ng/dL. Patients had a wide range of gland sizes, with a mean enucleated weight of 141 g (range 18–344 g). Mean reduction in hemoglobin was 16.9% following HoLEP. All patients managed to void postoperatively. All but one patient went home on postoperative day 1, and this patient went home on postoperative day 2. No patients required blood product transfusion or return to the operating room for clot irrigation postoperatively.

Conclusion

HoLEP is a reasonable option for Jehovah’s Witness and other patients with contraindications to blood product transfusion requiring surgical management of urinary symptoms due to enlarged prostate.

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Abbreviations

BPH:

Benign prostate hyperplasia

EPO:

Erythropoeitin

HoLEP:

Holmium laser enucleation of the prostate

LUTS:

Lower urinary tract symptoms

TURP:

Transurethral resection of the prostate

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Author information

Authors and Affiliations

  1. Department of Urology, University College London, London, UK

    Ashraf Selim

  2. Department of Urology, Indiana University School of Medicine, 1801 Senate Blvd. Suite 220, Indianapolis, IN, 46202, USA

    Charles U. Nottingham, Ronald S. Boris & James E. Lingeman

  3. Urology, Auckland City Hospital, 2 Park Road, Grafton, 1023, Auckland, New Zealand

    Nadya E. York

  4. Department of Urology, University of Michigan Health Systems, 1500 E Medical Center Dr SPC 5330, Ann Arbor, Michigan, 48109, USA

    Casey A. Dauw

  5. Department of Urology, University of Minnesota, 420 Delaware Street SE, Minneapolis, Minnesota, 55455, USA

    Michael S. Borofsky

Authors
  1. Ashraf Selim
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  2. Charles U. Nottingham
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  3. Nadya E. York
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  4. Casey A. Dauw
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  5. Michael S. Borofsky
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  6. Ronald S. Boris
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  7. James E. Lingeman
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Contributions

AS: protocol/project development, data collection or management, data analysis, and manuscript writing/editing. CUN: data collection or management, data analysis, and manuscript writing/editing. NEY: data collection or management, and data analysis. CAD: data collection or management, and data analysis. MSB: data collection or management, and data analysis. RSB: protocol/project development, data collection or management, and data analysis. JEL: protocol/project development, data collection or management, data analysis, and manuscript writing/editing.

Corresponding author

Correspondence to Charles U. Nottingham.

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Conflict of interest

The following disclosures are listed as follows. JE Lingeman is a consultant for Boston Scientific and Lumenis. CA Dauw is a consultant for Boston Scientific. MS Borofsky is a consultant for Boston Scientific and Auris Health. All other authors declare no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional review board approval was approved at our institution (number 101000224).

Informed consent

Informed consent was not obtained on patients given the retrospective nature of the study. The study was approved by the IRB at our institution (number 101000224).

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Selim, A., Nottingham, C.U., York, N.E. et al. Holmium laser enucleation of the prostate in Jehovah’s Witness patients. Int Urol Nephrol 52, 455–460 (2020). https://doi.org/10.1007/s11255-019-02331-x

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  • DOI: https://doi.org/10.1007/s11255-019-02331-x

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