MP20-12 Day-case Holmium LASER Enucleation of the prostate (HoLEP): success rate and predictive factors of D0 discharge after 10 years of clinical experience

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP20)1 May 2024MP20-12 Day-case Holmium LASER Enucleation of the prostate (HoLEP): success rate and predictive factors of D0 discharge after 10 years of clinical experience Xavier Lacroix, Clement Klein, Gregoire Capon, Eric Alezra, Vincent Estrade, Peggy Blanc, Franck Bladou, Jean-Christophe Bernhard, and Gregoire Robert Xavier LacroixXavier Lacroix , Clement KleinClement Klein , Gregoire CaponGregoire Capon , Eric AlezraEric Alezra , Vincent EstradeVincent Estrade , Peggy BlancPeggy Blanc , Franck BladouFranck Bladou , Jean-Christophe BernhardJean-Christophe Bernhard , and Gregoire RobertGregoire Robert View All Author Informationhttps://doi.org/10.1097/01.JU.0001008732.80104.31.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Most international guidelines recommend HoLEP for the surgical management of BPH, regardless of prostatic volume. The main advantages reported by randomized clinical studies are reduced perioperative bleeding, catheterization time, and length of hospitalization. HoLEP is mostly performed as a one-night stay; however, several studies have reported that HoLEP can be performed as a day-case procedure. We aimed at evaluating the feasibility and safety of day-case HoLEP in a large cohort of patients. METHODS: Clinical data for HoLEP procedures were prospectively collected on a dedicated database. We retrospectively analysed perioperative data of consecutive day-case procedures performed at our institution between January 2013 and April 2022 by only one experimented surgeon (n=396).Day-case success was defined as successful discharge within 12 hours of admission without any readmission within 48 hours. The protocol for day-case treatment included systematic bladder catheter insertion with continuous irrigation for approximately 2 hours and catheter removal on postoperative day 1. Uni- and multivariate analysis were performed to identify predictive factors of failure. RESULTS: In total, 89% of patients (n=354) were successfully discharged within 12 hours and 83% (n=328) were not readmitted within 48 hours. The main reason for discharge failure was hematuria requiring continuous bladder irrigation. In univariate analysis, age (p=0.04), PSA (p=0.03), prostate volume (p=0.003), operating time (p=0.001), resected tissue weight (p=0.001), and indwelling catheter (p=0.007) were associated with discharge failure. In multivariate analysis, prostate volume over 90mL (p=0.05) was the only risk factor associated with discharge failure. CONCLUSIONS: Day-case HoLEP is a reliable and safe procedure, with a high success rate. In our experience, the most important factor leading to failure to discharge patient within 12 hours of surgery was prostate volume. The success rate was 82% in patients with prostate volume > 90mL. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e324 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Xavier Lacroix More articles by this author Clement Klein More articles by this author Gregoire Capon More articles by this author Eric Alezra More articles by this author Vincent Estrade More articles by this author Peggy Blanc More articles by this author Franck Bladou More articles by this author Jean-Christophe Bernhard More articles by this author Gregoire Robert More articles by this author Expand All Advertisement PDF downloadLoading ...