The following is a summary of “Adoption and Outcomes of Holmium Laser Enucleation of the Prostate in the United States,” published in the Septemebr 2023 issue of Urology by Weinstein, et al.

For a study, researchers sought to investigate the utilization of holmium laser enucleation of the prostate (HoLEP) within a large real-world cohort and compare its safety, readmission, and retreatment rates to other commonly used endoscopic surgical interventions for benign prostatic hyperplasia (BPH). The comparative procedures included transurethral resection of the prostate (TURP), photoselective vaporization of the prostate, and prostatic urethral lift.

The study identified men who underwent endoscopic treatments for BPH between 2000 and 2019 using the Premier Healthcare Database (n = 218,793). The analysis involved assessing the relative proportion of each procedure performed and examining annual physician volume data to discern trends in adoption and utilization. Readmission and retreatment rates were determined at both 30- and 90 days postoperation. Multivariable logistic regression was employed to evaluate the association between procedure type and outcomes.

HoLEP constituted 3.2% (n = 6,967) of all BPH procedures performed between 2000 and 2019, with its prevalence increasing from 1.1% in 2008 to 4% in 2019. Patients undergoing HoLEP exhibited lower odds of 90-day readmission compared to TURP (Odds ratio (OR) 0.87, P = 0.025). HoLEP demonstrated similar odds of retreatment as TURP at both 1-year (OR 0.96, P = 0.7) and 2-years (OR 0.98, P = 0.9). In contrast, patients undergoing photoselective vaporization of the prostate and prostatic urethral lift were more likely to experience retreatment within 2 years (OR 1.20, P < 0.001; OR 1.87, P < 0.001).

HoLEP emerged as a safe therapeutic option for BPH, showcasing lower readmission rates and comparable retreatment rates to the gold standard TURP. Despite these favorable outcomes, the utilization of HoLEP has lagged behind other endoscopic procedures and remains relatively low.

Source: goldjournal.net/article/S0090-4295(23)00469-7/fulltext