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Abstract：
OBJECTIVE: To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) in a large prospective cohort of patients with benign prostatic hyperplasia (BPH) through systematic follow-up at a single institution.
METHODS: Clinical outcomes were analyzed between August 2008 and June 2022. Patients were followed-up at 2 weeks, 3 months and 6 months postoperatively.
RESULTS: A total of 3,000 patients (mean age, 69.6±7.7 years) underwent HoLEP. Baseline total International Prostate Symptom Score (IPSS) was 19.3±7.7 and maximum flow rate (Qmax) was 9.4±4.8 mL/s. Mean total prostate volume was 67.7±3.4 mL. Total operation time was 60.7±31.5 minutes, and catheterization time was 1.0 days (range, 1.0-1.0 days). At 6 months postoperatively, the total IPSS decreased to 6.6±5.8 and Qmax increased to 22.2±11.3 mL/s. Complications at 6 months postoperatively included stress urinary incontinence (SUI) in 36 patients (1.9%), urgency urinary incontinence (UUI) in 25 (1.3%), bladder neck contracture (BNC) requiring transurethral incision (TUI) in 16 (0.5%), and urethral stricture in 29 (1.0%). Eleven patients (0.4%) with prostatic fossa stones required stone removal. Sixty-one patients (2.0%) required secondary surgery (transurethral coagulation, 16 [0.5%]; TUI for BNC, 16 [0.5%]; stone removal for prostatic fossa stones, 11 [0.4%]; and endoscopic internal urethrotomy for urethral stricture, 18 [0.6%]).
CONCLUSIONS: Mid-term follow-up results after HoLEP in BPH patients showed excellent efficacy and low complication rates. Unlike previous reports, the incidence of SUI and UUI after HoLEP was low, but the occurrence of de novo stone formation in prostatic fossa was notable.
METHODS: Clinical outcomes were analyzed between August 2008 and June 2022. Patients were followed-up at 2 weeks, 3 months and 6 months postoperatively.
RESULTS: A total of 3,000 patients (mean age, 69.6±7.7 years) underwent HoLEP. Baseline total International Prostate Symptom Score (IPSS) was 19.3±7.7 and maximum flow rate (Qmax) was 9.4±4.8 mL/s. Mean total prostate volume was 67.7±3.4 mL. Total operation time was 60.7±31.5 minutes, and catheterization time was 1.0 days (range, 1.0-1.0 days). At 6 months postoperatively, the total IPSS decreased to 6.6±5.8 and Qmax increased to 22.2±11.3 mL/s. Complications at 6 months postoperatively included stress urinary incontinence (SUI) in 36 patients (1.9%), urgency urinary incontinence (UUI) in 25 (1.3%), bladder neck contracture (BNC) requiring transurethral incision (TUI) in 16 (0.5%), and urethral stricture in 29 (1.0%). Eleven patients (0.4%) with prostatic fossa stones required stone removal. Sixty-one patients (2.0%) required secondary surgery (transurethral coagulation, 16 [0.5%]; TUI for BNC, 16 [0.5%]; stone removal for prostatic fossa stones, 11 [0.4%]; and endoscopic internal urethrotomy for urethral stricture, 18 [0.6%]).
CONCLUSIONS: Mid-term follow-up results after HoLEP in BPH patients showed excellent efficacy and low complication rates. Unlike previous reports, the incidence of SUI and UUI after HoLEP was low, but the occurrence of de novo stone formation in prostatic fossa was notable.
摘要：
目的：通过在单一机构的系统随访，评估良性前列腺增生（BPH）患者的大型前瞻性队列中钬激光前列腺摘除术（HoLEP）的有效性和安全性。
方法：分析了2008年8月至2022年6月间的临床结果。患者随访2周,术后3个月和6个月。
结果：共有3,000名患者（平均年龄，69.6±7.7年)接受HoLEP。基线国际前列腺症状总评分（IPSS）为19.3±7.7，最大流速（Qmax）为9.4±4.8mL/s。平均总前列腺体积为67.7±3.4mL。总手术时间为60.7±31.5分钟,导管插入时间为1.0天(范围，1.0-1.0天）。术后6个月，总IPSS降至6.6±5.8，Qmax升至22.2±11.3mL/s。术后6个月的并发症包括压力性尿失禁（SUI）36例（1.9％），急迫性尿失禁（UUI）25（1.3%），膀胱颈挛缩症（BNC）需要经尿道切开（TUI）16（0.5％），尿道狭窄29例(1.0%)。11例前列腺窝结石患者（0.4％）需要清除结石。61例患者（2.0％）需要二次手术（经尿道电凝，16[0.5%]；BNC的TUI，16[0.5%]；前列腺窝结石取石，11[0.4%]；尿道狭窄的内镜下尿道内切开术，18[0.6%]）。
结论：BPH患者HoLEP术后中期随访结果显示疗效好，并发症发生率低。与以前的报告不同，HoLEP后SUI和UUI的发生率较低，但前列腺窝发生了从头结石。
方法：分析了2008年8月至2022年6月间的临床结果。患者随访2周,术后3个月和6个月。
结果：共有3,000名患者（平均年龄，69.6±7.7年)接受HoLEP。基线国际前列腺症状总评分（IPSS）为19.3±7.7，最大流速（Qmax）为9.4±4.8mL/s。平均总前列腺体积为67.7±3.4mL。总手术时间为60.7±31.5分钟,导管插入时间为1.0天(范围，1.0-1.0天）。术后6个月，总IPSS降至6.6±5.8，Qmax升至22.2±11.3mL/s。术后6个月的并发症包括压力性尿失禁（SUI）36例（1.9％），急迫性尿失禁（UUI）25（1.3%），膀胱颈挛缩症（BNC）需要经尿道切开（TUI）16（0.5％），尿道狭窄29例(1.0%)。11例前列腺窝结石患者（0.4％）需要清除结石。61例患者（2.0％）需要二次手术（经尿道电凝，16[0.5%]；BNC的TUI，16[0.5%]；前列腺窝结石取石，11[0.4%]；尿道狭窄的内镜下尿道内切开术，18[0.6%]）。
结论：BPH患者HoLEP术后中期随访结果显示疗效好，并发症发生率低。与以前的报告不同，HoLEP后SUI和UUI的发生率较低，但前列腺窝发生了从头结石。
