Holmium laser prostatic resection for patients presenting with acute urinary retention

Abstract

To compare the outcomes of patients presenting with and without acute urinary retention (AUR) who were treated with 100-W holmium laser resection of the prostate (HoLRP), as laser therapies, including HoLRP, have been used for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH), but the effectiveness of HoLRP for patients with AUR has not been fully elucidated. The medical records of 87 patients who had HoLRP were reviewed, and prospective questionnaires aimed at determining patients' American Urologic Association Symptom Index (AUA-SI) and Quality-of-Life (QoL) scores and medication usage were also obtained. Statistical analyses were used to compare the clinical characteristics and outcomes between patients with and with no AUR for up to 2 years after HoLRP. All patients had the catheter removed successfully by 1 month after surgery; those presenting with AUR tended to have a greater improvement in clinical outcomes than those with no AUR, including a mean AUA-SI score decrease by approximately 13 and approximately 8 points, and a QoL score decrease by approximately 2 and approximately 1.4 points, respectively. These decreases were maintained throughout the study period. Patients with AUR had significantly greater decreases in their postvoid residual urine volume than those with no AUR. Serum prostate-specific antigen levels also had a modest but sustained decrease (14%) in both groups. There were no significant decreases in the reported use of BPH-related medications after surgery in either group. HoLRP (100 W) is a safe and effective surgical therapy for patients presenting with AUR. The present results suggest that the short- and long-term outcomes of these patients are similar between men presenting with and with no AUR.