Abstract
Purpose
Holmium laser enucleation of prostate (HoLEP) is an effective surgical procedure in men with BPH. Due to the increase in the use of medical therapy for BPH related lower urinary symptoms more octogenarians are presenting in a delayed fashion with significant symptoms and urinary retention. We evaluate the feasibility and safety of octogenarians undergoing HoLEP.
Methods
We performed a retrospective review of HoLEPs at our institution from July 2018 to December 2019. Patients were stratified into two groups based on age: < 80 and ≥ 80.
Results
A total of 458 patients were identified, with 74 (16.2%) ≥ 80. In patients ≥ 80, prostate volume was higher (p < 0.0005), there was a higher rate of antiplatelet/anticoagulation (p = 0.029) use, and a lower rate of alpha-blocker use (p = 0.0016). As expected, ASA scores which correlate with increasing number of concomitant diseases were greater in the ≥ 80 cohort (p = 0.016). There was no significant difference in intraoperative complications (p = 0.14), 90 day complication (p = 0.34), readmission rates (p = 0.425) or emergency room visits between groups (p = 0.15).
Conclusions
Despite higher medical comorbidities and increased rates of anticoagulation in octogenarians, there is no increase in operative or postoperative complication rates. Age alone should not be used as exclusion criteria for HoLEP.
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JH: project development, data collection, manuscript writing. DA: data collection, manuscript writing/editing, protocol/project development. SK: manuscript writing. CN: protocol/project development, data collection/management. TL: protocol/project development, data collection/management. AK: protocol/project development, data analysis, manuscript writing/editing. MR: protocol/project development, data analysis, manuscript writing/editing.
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AEK—paid consultant for Lumenis and Boston Scientific. No other authors have disclosures.
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Heiman, J., Agarwal, D., Komanapalli, S. et al. Outcomes of octogenarians undergoing holmium laser enucleation of prostate. World J Urol 40, 1751–1754 (2022). https://doi.org/10.1007/s00345-022-04053-9
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DOI: https://doi.org/10.1007/s00345-022-04053-9