Objective: To evaluate the outcome of Holmium laser enucleation of the prostate (HoLEP) in the known presence of Prostate Cancer PCa and concomitant lower urinary tract symptoms (LUTS).
Patients and Methods: We retrospectively identified 62 patients who underwent HoLEP for LUTS in the known presence of PCa at our center. Perioperative data were assessed including complications, functional outcomes and quality of life (QoL). Giving respect to different disease characteristics, patients were stratified according to treatment strategy setting into palliative- (I), radiation - (II) and surveillance- (III) patients and compared accordingly.
Results: Median follow up (FU) of the entire study cohort was 27 months (range: 2-65 months). Medians of functional parameters (international prostate symptom score (IPSS): 18.5 vs. 4.5, QoL: 4 vs. 1, maximal flow rate: 9.0 vs. 18.8ml/s and residual urine: 100 vs. 0ml, all p<0.05) improved significantly in all groups. Perioperative complications were low and without any statistically significant difference between the groups. Postoperatively, voiding was successful in 90.3% of all patients; at last FU 17% suffered some degree of urinary incontinence. Treatment strategy groups showed comparable functional outcomes after HoLEP.
Conclusion: In the presence of PCa and LUTS HoLEP represents a feasible, safe and effective treatment option for patients unfit or without indication for radical prostatectomy. This applies as well in a palliative situation of advanced, obstructive PCa as for patients with LUTS who are scheduled for RT or surveillance in presumably indolent disease.
Written by:
Becker A, Placke AK, Kluth LA, Schwarz R, Isbarn H, Chun FK, Heuer R, Schlomm T, Seiler D, Engel O, Fisch M, Graefen M, Ahyai SA. Are you the author?
University Medical Centre Hamburg-Eppendorf, Urology, Hamburg, Hamburg, Germany;
Reference: J Endourol. 2013 Oct 22. Epub ahead of print.
doi: 10.1089/end.2013.0432
PubMed Abstract
PMID: 24147796
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