Holmium laser enucleation of the prostate (HoLEP) in short‐circuit outpatient care: Is prostatic volume a limiting factor?

• Published in: Lower urinary tract symptoms 2024-07, Vol.16 (4), p.e12525-n/a
• Main Authors: Maria, Sánchez Rodríguez, Franco, Marco, Freixa Sala, Roger, Gasanz Serrano, Carlos, Bernardello Ureta, Mauro, Bultó Gonzalvo, Ramón, Cervera Alcaide, Jordi, Casanova García, Carla, García Puche, Mireia, Segura Alabart, Maria, Areal Calama, Juan José, Ágreda Castañeda, Fernando
• Format: Article
• Language: English
• Subjects: Aged; Ambulatory Care - methods; Ambulatory Surgical Procedures - methods; benign prostatic hyperplasia; HoLEP; Humans; Laser Therapy - methods; Lasers, Solid-State - therapeutic use; Length of Stay; Male; Middle Aged; Organ Size; outcome assessment; outpatient care; Prostate; Prostate - surgery; Prostatectomy - adverse effects; Prostatectomy - methods; Prostatic Hyperplasia - surgery; Treatment Outcome
• ISSN: 1757-5664; 1757-5672; 1757-5672
• DOI: 10.1111/luts.12525

Introduction and Objectives Our goals were to study prostatic volume as a limiting factor after HoLEP surgery with short‐circuit outpatient care (4 h) and to define other factors that affect the success of the proposed circuit. Materials and Methods An observational analysis and review was performed using a prospective database. Preoperative, intraoperative, and postoperative variables were included for patients who were scheduled for short‐circuit outpatient care (SCOC) and who underwent HoLEP between 2020 and 2023. We defined SCOC as a postoperative hospital stay of 4 h. Subjects who required more than 4 h in hospital were categorized as conventional hospital admission (CHA). A descriptive populational study was conducted, expressing the mean using a 95% confidence interval and percentages for the continuous variables. In order to analyze them, we used the Student's t‐test for the continuous variables and the chi‐squared test for the categorical variables. Results Sixty‐eight patients were included, 54 of which completed SCOC, which represented a success ratio of 79.5%. The mean age and prostatic volume of the whole cohort were 68.9 (±6.8) years and 79.5 (±29.1) mL, respectively. We found no significant differences in age, prostatic volume, antiplatelet drug use, indwelling bladder catheter, or applied energy among the subjects who completed SCOC and those who required CHA. No patient was presented with a complication of Grade 3 (or higher) in the modified Clavien–Dindo classification. At the six‐month follow‐up, no differences were observed in the uroflowmetry or International Prostate Symptoms Score variables. Conclusions Prostatic volume does not seem to be a limiting factor after undergoing HoLEP with short‐circuit outpatient care.