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Efficacy and safety of Holmium laser enucleation of prostate (HoLEP) in patients with underlying neurologic disease

Kim, M1; Choo, MS1; Ahn, TY1

1: Asan Medical Center, Korea, South

Objectives: Neurologic disease can cause the neurogenic bladder which can compromise the treatment outcome of HoLEP in patients with benign prostatic hyperplasia (BPH). Moreover, anticoagulants are frequently administered in those patients. We compared the efficacy and safety outcomes of HoLEP in BPH patients with or without neurologic disease.

Methods: We retrospectively reviewed the medical records, and pre-operative urodynamic study (UDS) results of BPH patients who underwent HoLEP between June 2009 and December 2015.

Results: Of the 317 patients who received the HoLEP, 26 (8.2%) patients had underlying neurologic diseases. Neurologic disease group was more frequently administered anticoagulants than non-neurologic group (69.2 vs. 18.6%; p <0.001). However, neurologic disease group demonstrated similar patient characteristics and pre-operative urologic findings with non-neurologic disease group as shown in the Table. Two groups demonstrated similar operation time (non-neurologic disease group vs. neurologic disease group; 116.2 vs. 107.8 min, p=0.291), transfusion rate (0.3 vs. 0.0%, p=0.765), hospital stay (6.1 vs. 5.6 days, p=0.245), catheter duration (3.3 vs. 3.5 days, p=0.593), re-catheterization rate (5.2 vs. 0.0%, p=0.236). At median follow-up of 6 months, two groups demonstrated similar outcome parameters such as Qmax (19.6 vs. 16.6 mL/sec, p=0.088), PVR (27.9 vs. 35.2 mL, p=0.467), IPSS-emptying (3.1 vs. 3.6, p=0.645), IPSS-storage (4.3 vs. 3.3, p=0.219), and IPSS-QoL (1.6 vs. 2.0, p=0.470). Rates of complications such as incontinence (6.7 vs. 9.1%, p=0.671), urinary tract infection (0.8 vs. 0.0%, p=0.667), urethral stricture (1.7 vs. 4.5%, p=0.347) were not also different between two groups.

Conclusions: Efficacy and safety outcomes of HoLEP in patients with underlying neurologic diseases did not compromise compared to those of patient without neurologic diseases. HoLEP can be a good treatment option for BPH patients with underlying neurologic disease.


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