Safety and feasibility study of holmium laser enucleation of the prostate (HOLEP) on patients receiving dual antiplatelet therapy (DAPT)

Abstract

Objective: To evaluate the safety and feasibility of Holmium laser enucleation of the prostate (HoLEP) in patients receiving dual antiplatelet therapy (DAPT).

Methods: From March 2013 to August 2016, we retrospectively analyzed 1124 benign prostatic hyperplasia (BPH) patients undergoing HoLEP and divided into four groups: 56 cases receiving DAPT therapy (group A); 72 patients treated with continuous single antiplatelet (AP) therapy (group B); 41 patients treated with single AP therapy but intermittent during preoperative time (group C) and 955 cases had no AP therapy (group D). Patients' baseline characteristics, 1-year clinical outcomes, rates of postoperative bleeding and complications were presented in this study.

Results: All patients received successful operations and no severe postoperative complications occurred. Only one patient in Group D required transfusion. The enucleation time and catheterization time for the DAPT patients were the longest among four groups (p < 0.001, respectively). The overall complications rates within 30 days were 23.2% (13/56) in Group A, 27.8% (20/72) in Group B, 19.5% (8/41) in Group C, and 27.0% (258/955) in Group D, respectively (p = 0.678). By the 12 months, the international prostate symptom scores (IPSS), quality of life scores (QOL) and residual urine volume (RUV) in all groups have been significantly improved.

Conclusion: HoLEP in patients receiving DAPT after coronary artery stunting showed similar results to those achieved in patients receiving single AP therapy or non-AP therapy. It can be a good option, which the urologists can offer to those patients with symptomatic benign prostatic hyperplasia refractory to medical treatment.

Keywords: Benign prostate hyperplasia; Dual antiplatelet therapy; Holmium laser enucleation of the prostate; Lower urinary tract symptoms.