Holmium laser enucleation of the prostate (HoLEP) for dialysis patients with benign prostatic hyperplasia

Abstract

Between December 2012 and November 2013, five hemodialysis patients with BPH received HoLEP. The mean age at the time of operation was 71.2 years (68-75 years), the mean urine volume was 420 mL/day (100-700 mL/day), the mean hemodialysis duration was 57.4 months (18-99 months), and the mean estimated prostatic volume was 36.8 mL (20.2-48.9 mL). Chief complaints of three cases were urinary retention, and those in the other 2 cases were nocturia and residual feeling. HoLEP was successfully performed under the condition of continuous oral anticoagulation. The mean enucleation time was 50 minutes (22-104 minutes) and the mean enucleated tissue weight was 11.8 grams (1-27 g). The mean hemoglobin loss after HoLEP was 1.8 g/dL (0-5.1 g/dL) and no patient needed blood transfusion. International Prostate Symptom Score and quality-of-life score were significantly improved 1 month after HoLEP. HoLEP has excellent hemostatic properties, and is a safe and effective procedure for hemodialysis patients with BPH.