Department of Urology, Gulhane Training and Research Hospital, Health Sciences University, Ankara, Turkey.
Department of Urology, Acıbadem University Ankara Hospital, Ankara, Turkey.
World J Urol. 2021 Jul;39(7):2605-2611. doi: 10.1007/s00345-020-03518-z. Epub 2020 Nov 13.
Holmium laser enucleation of the prostate (HoLEP) has recently become the recommended treatment for prostate in all sizes in benign prostate hyperplasia surgery. A recent prostate biopsy performed prior to the HoLEP procedure can make surgeons concerned about the surgery. We aimed to investigate the per- and postoperative outcomes of the HoLEP procedure in patients who underwent prostate biopsy and to evaluate the most appropriate surgery time after biopsy.
The data of 160 patients who underwent HoLEP by a single surgeon between March 2017 and December 2019 were retrospectively reviewed. The patients were divided into two groups, Group 1 consisted of 80 patients without prostate biopsy and Group 2 consisted of 80 patients with prior prostate biopsy. All HOLEP procedures in group 2 were performed at least 2 weeks following biopsy. Per- and postoperative outcomes, complications were evaluated.
No significant differences were found between groups in terms of by enucleation time, efficiency of laser, efficiency of enucleation, hospitalization time, and catheterization removal time. Only morcellation time was shorter in biopsy naïve patients. There were no statistical differences in postoperative outcomes. Previous prostate biopsy did not affect the continence status in our study group. There were not any Clavien grade 4 or higher complications. Urinary tract infection was higher in early post-biopsy period, there was no difference among the groups. CONCLUSıON: Our study confirms that HoLEP is a safe and efficient surgical procedure for the patients with prior prostate biopsy. We believe that it can be safely performed 2nd week following prostate biopsy.
钬激光前列腺剜除术（HoLEP）最近已成为治疗良性前列腺增生中所有大小前列腺的推荐手术方法。HoLEP 手术前进行的最近一次前列腺活检可能会让外科医生对手术感到担忧。我们旨在研究接受过前列腺活检的患者接受 HoLEP 手术的围手术期结果，并评估活检后最合适的手术时间。
回顾性分析了 2017 年 3 月至 2019 年 12 月期间由一名外科医生进行的 160 例接受 HoLEP 治疗的患者的数据。这些患者被分为两组，第 1 组包括 80 例未进行前列腺活检的患者，第 2 组包括 80 例进行过前列腺活检的患者。第 2 组的所有 HoLEP 手术均在活检后至少 2 周进行。评估了围手术期和术后的结果以及并发症。
两组在剜除时间、激光效率、剜除效率、住院时间和导尿管拔除时间方面无显著差异。只有未进行过活检的患者的碎石时间更短。术后结果无统计学差异。在我们的研究组中，既往前列腺活检并未影响控尿状态。没有任何 Clavien 分级 4 级或更高的并发症。尿路感染在早期活检后更为常见，但组间无差异。
我们的研究证实 HoLEP 是一种安全有效的前列腺增生手术方法，对于既往有前列腺活检的患者也同样适用。我们认为可以在前列腺活检后 2 周内安全地进行该手术。
