Effect of the “five-step” method holmium laser enucleation for benign prostatic hyperplasia with  large volume on urinary control and sexual protection

doi:10.3969/j.issn.1006-7795.2025.02.012

Abstract

Abstract: Objective To analyze the effects of “five-step” Holmium laser enucleation on urinary continence and sexual function of the patients with the large volume prostate. Methods Data of 105 patients with massive prostatic hyperplasia admitted to the First People's Hospital of Hefei from June 2021 to May 2024 were retrospectively analyzed. Among them,52 patients were treated with the five-step Holmium laser enucleation of prostate (HoLEP),and the others were treated with transurethral plasma kinetic enucleation of the prostate(TUKEP). The perioperative data were collected, and the incidence of urinary incontinence and the changes of sexual function　［incidence of retrograde ejaculation and international index of erectile function-5 (IIEF-5) score］ were observed in the two groups.The changes of maximum urine flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QOL) score, prostate specific antigen (PSA) were compared between the two groups before and 6 months after surgery.Results There were no significant differences in indwelling catheterization time and weight of resected glands(P>0.05).The postoperative hemoglobin decline, the average operation time in the HoLEP group was significantly reduced than that in the TUKEP group(P<0.05). The index of C-reactive protein after surgery in the two groups was higher than before surgery (P< 0.05), but HoLEP group was better than that of TUKEP group (P< 0.05). After 6 months, there were no significant differences in PSA, Qmax, IPSS, QOL and IIEF-5 between the two groups (P> 0.05).The incidence of transient urinary incontinence and retrograde ejaculation in the HoLEP group was significantly better than that in the TUKEP group (P< 0.05).Conclusion The “five-step” HoLEP method is effective in the treatment for large benign prostatic hyperplasia with large volume. Compared with TUKEP group, HoLEP showed the same treatment efficacy, the less impact on urinary control and retrograde ejaculation, and the more improved postoperative QOL.The “five-step” HoLEP is feasible and safe with promising clinical application prospects.

Key words: benign prostatic hyperplasia, enucleation of the prostate, Holmium laser, surgical technique, efficacy

CLC Number:

R697+.3

Wen Zhu, , Zhang Chao, Zhang Xiansheng. Effect of the “five-step” method holmium laser enucleation for benign prostatic hyperplasia with large volume on urinary control and sexual protection[J]. Journal of Capital Medical University, 2025, 46(2): 263-268.

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Effect of the “five-step” method holmium laser enucleation for benign prostatic hyperplasia with large volume on urinary control and sexual protection

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