to evaluate the impact of Indwelling Urinary Catheters (IUC) on perioperative and functional outcomes, as well as the safety profile, of High-Power HoLEP for the treatment of prostate gland volumes exceeding 200 cc.
A retrospective analysis was conducted on 237 patients with prostate volumes > 200 cc who underwent HoLEP between January 2016 and December 2022. Patients were included based on specific criteria, such as an International Prostate Symptom Score (IPSS) > 7 and a maximum urinary flow rate (Qmax) < 15 mL/s. Patients were categorized into two groups: Group 1 included those with IUC prior to surgery, while Group 2 comprised patients without it.
A total of 237 patients with prostate volumes exceeding 200 cc underwent HoLEP, and were categorized into Group 1 (n = 63) and Group 2 (n = 174), with Group 1 exhibiting higher Charlson Comorbidity Index and BMI. Postoperative outcomes indicated a higher incidence of urinary tract infections in Group 1, as well as worse IPSS, Qmax, and PVR at 3 months; however, by the 1-year follow-up, both groups demonstrated comparable results. Longitudinal analysis revealed that both groups experienced significant functional and symptomatic improvements over time, with Group 2 showing rapid early gains that stabilized, whereas Group 1 exhibited continuous improvement from 3 months to 1 year.
HoLEP is an effective treatment for very large prostate volumes in patients with IUC. Although these patients are at a higher risk for UTI and initial lower Qmax, these outcomes improve by one year.
World journal of urology. 2025 Apr 14*** epublish ***
Matteo Tallè, Carlo Giulioni, Alessio Papaveri, Francesco Mengoni, Roberto Orciani, Savio Domenico Pandolfo, Ciro Imbimbo, Felice Crocetto, Daniele Castellani, Thomas Herrmann, Vineet Gauhar, Angelo Cafarelli
Department of Urology, Casa di Cura Villa Igea, Ancona, 60127, Italy., Department of Urology, Casa di Cura Villa Igea, Ancona, 60127, Italy. ., Department of Urology, University of L'Aquila, L'Aquila, 67100, Italy., Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples "ederico II", Naples, 80131, Italy., Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Ancona, 60126, Italy., Department of Urology, Spital Thurgau AG, Kantonsspital Frauenfeld, Pfaffenholzstrasse 4, Frauenfeld, 8501, CH, Switzerland., Department of Urology, Ng Teng Fong General Hospital, Singapore, 126817, Singapore.