Holmium laser enucleation of the prostate (HoLEP) is a size-independent surgical option for treating benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) with excellent, durable functional outcomes.
The prevalence of LUTS secondary to BPH and prostate cancer both increase with age, although the two diseases develop independently. Urologists often face a diagnostic dilemma, as men with LUTS secondary to BPH might also present with an elevated PSA and, therefore, need a diagnostic work-up to exclude prostate cancer. Nevertheless, ~15% of men with a negative elevated PSA work-up will undergo HoLEP and will be diagnosed with incidental prostate cancer at the time of HoLEP. Indeed, prostate cancer is often found in men undergoing HoLEP, and this situation can be challenging to manage. Variables associated with the detection of incidental prostate cancer, strategies to reduce incidental prostate cancer, as well as the natural history and management of this condition have been extensively studied, but further work in this area is still needed.
Nature reviews. Urology. 2022 Nov 23 [Epub ahead of print]
Matthew S Lee, Mark A Assmus, Jenny Guo, Mohammad R Siddiqui, Ashley E Ross, Amy E Krambeck
Ohio State University School of Medicine, Department of Urology, Columbus, OH, USA. ., University of Calgary, Institute of Urology, Calgary, Alberta, Canada., Feinberg School of Medicine, Northwestern University, Department of Urology, Chicago, IL, USA.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36418491