Clinical Outcomes and Efficacy of Enbloc Holmium Laser Enucleation of the Prostate (HoLEP): A Retrospective Analysis of 60 Patients

Yıl 2025, Cilt: 6 Sayı: 3, 243 - 251, 28.09.2025

Resul Sobay , Hasan Samet Güngör , Abdurrahman İnkaya , Murat Beyatlı , Ahmet Tahra , Eyüp Veli Küçük

https://doi.org/10.47482/acmr.1721801

Öz

Background: Benign prostatic hyperplasia (BPH) affects a significant proportion of aging men, causing lower urinary tract symptoms and decreased quality of life. Holmium Laser Enucleation of the Prostate (HoLEP) has emerged as a minimally invasive surgical treatment, with the enbloc technique representing a refinement of the procedure.
Methods: We retrospectively analyzed data from 60 patients who underwent Enbloc HoLEP at our institution. Patient characteristics, perioperative parameters, and clinical outcomes including American Urological Association Symptom Scores (AUASS), Quality of Life (QoL) scores, post-void residual volumes (PVR), and complication rates were assessed.
Results: Mean patient age was 65.5 ± 9.1 years with mean prostate volume of 98.3 ± 34.7 cc. Following Enbloc HoLEP, AUASS significantly decreased from 23.3 ± 6.0 to 6.1 ± 2.0 (p<0.001), QoL scores improved from 3.9 ± 0.9 to 1.1 ± 0.8 (p<0.001), and PVR decreased from 212.3 ± 132.6 cc to 37.7 ± 16.3 cc (p<0.001). Mean operative time was 133.1 ± 28.0 minutes with laser energy of 209.8 ± 44.7 kJ. Continence rates were 96.7% at discharge, 78.3% at 3 months, 91.7% at 6 months, and 96.7% at 12 months. Overall complication rate was 15.0%, most being minor (Clavien grades I-II).
Conclusions: Enbloc HoLEP is a safe and effective procedure for treating BPH, demonstrating significant improvements in urinary symptoms, quality of life, and bladder emptying with minimal complications and excellent long-term continence outcomes.

Anahtar Kelimeler

Benign prostatic hyperplasia , Holmium laser enucleation of prostate , Enbloc technique , Lower urinary tract symptoms , Minimally invasive surgery

Prostatın Enbloc Holmium Lazer Enükleasyonunun (HoLEP) Klinik Sonuçları ve Etkinliği: 60 Hastanın Retrospektif Analizi

Öz

Arka plan: Benign prostat hiperplazisi (BPH) yaşlanan erkeklerin önemli bir bölümünü etkileyerek alt üriner sistem semptomlarına ve yaşam kalitesinde azalmaya neden olmaktadır. Prostatın Holmiyum Lazer Enükleasyonu (HoLEP) minimal invaziv bir cerrahi tedavi olarak ortaya çıkmıştır ve enblok teknik prosedürün geliştirilmiş halini temsil etmektedir.
Yöntemler: Kurumumuzda Enblok HoLEP uygulanan 60 hastanın verilerini retrospektif olarak analiz ettik. Hasta özellikleri, perioperatif parametreler ve American Urological Association Symptom Scores (AUASS), Quality of Life (QoL) skorları, post-void rezidüel volüm (PVR) ve komplikasyon oranları dahil klinik sonuçlar değerlendirildi.
Bulgular Ortalama hasta yaşı 65.5 ± 9.1 yıl ve ortalama prostat hacmi 98.3 ± 34.7 cc idi. Enblok HoLEP sonrası AUASS anlamlı olarak 23.3 ± 6.0'dan 6.1 ± 2.0'a (p<0.001), yaşam kalitesi skorları 3.9 ± 0.9'dan 1.1 ± 0.8'e (p<0.001) ve PVR 212.3 ± 132.6 cc'den 37.7 ± 16.3 cc'ye (p<0.001) düştü. Ortalama ameliyat süresi 133.1 ± 28.0 dakika ve lazer enerjisi 209.8 ± 44.7 kJ idi. Kontinans oranları taburculukta %96.7, 3. ayda %78.3, 6. ayda %91.7 ve 12. ayda %96.7 idi. Genel komplikasyon oranı %15,0 idi ve çoğu minördü (Clavien dereceleri I-II).
Sonuçlar: Enblok HoLEP, BPH tedavisinde güvenli ve etkili bir prosedürdür ve üriner semptomlarda, yaşam kalitesinde ve mesane boşaltımında minimal komplikasyon ve mükemmel uzun süreli kontinans ile önemli iyileşmeler göstermektedir.

Anahtar Kelimeler

minimal invaziv cerrahi , alt üriner sistem semptomları , enblok teknik , Holmium lazerle prostat enükleasyonu , benign prostat hiperplazisi

Kaynakça

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