Outcomes of Holmium Laser Enucleation of the Prostate in Patients with Chronic Painless Urinary Retention and Postvoid Residual Urine ≥ 1‐l: A Critical Evaluation at the Extreme Ends of the Spectrum

Key Points

• This study evaluates the outcomes of HoLEP in men with chronic painless urinary retention and significant postvoid residual urine.
• Retrospective review of men undergoing HoLEP from July 2017 to May 2024.
• Identified patients with chronic painless urinary retention and postvoid residual urine > 1 l.
• Excluded patients with acute-on-chronic retention, bladder diverticulum, or neurogenic bladder.
• Conducted a matched-pair analysis comparing study and control groups.
• Analyzed demographic, perioperative, and postoperative voiding parameters and complications.
• Out of 660 patients, 20 had a baseline postvoid residual urine > 1 l.
• The catheterization rate was higher in the study group (50% vs. 17.5%, p < 0.005).
• 22% of the study group failed a voiding trial on the first postoperative day, compared to 5.2% in the control group, though not statistically significant.
• By one month post-HoLEP, all patients in the study group were catheter-free and voiding spontaneously.
• No significant differences in postoperative voiding improvements and complications were found between the groups.