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. 2022 Jul;40(7):1751-1754.
doi: 10.1007/s00345-022-04053-9. Epub 2022 May 28.

Outcomes of octogenarians undergoing holmium laser enucleation of prostate

Joshua Heiman  1 , Deepak Agarwal  2 , Sarah Komanapalli  2 , Charles Nottingham  2 , Tim Large  2 , Amy Krambeck  2 , Marcelino Rivera  2
Affiliations

Outcomes of octogenarians undergoing holmium laser enucleation of prostate

Joshua Heiman et al. World J Urol. 2022 Jul.

Abstract

Purpose: Holmium laser enucleation of prostate (HoLEP) is an effective surgical procedure in men with BPH. Due to the increase in the use of medical therapy for BPH related lower urinary symptoms more octogenarians are presenting in a delayed fashion with significant symptoms and urinary retention. We evaluate the feasibility and safety of octogenarians undergoing HoLEP.

Methods: We performed a retrospective review of HoLEPs at our institution from July 2018 to December 2019. Patients were stratified into two groups based on age: < 80 and ≥ 80.

Results: A total of 458 patients were identified, with 74 (16.2%) ≥ 80. In patients ≥ 80, prostate volume was higher (p < 0.0005), there was a higher rate of antiplatelet/anticoagulation (p = 0.029) use, and a lower rate of alpha-blocker use (p = 0.0016). As expected, ASA scores which correlate with increasing number of concomitant diseases were greater in the ≥ 80 cohort (p = 0.016). There was no significant difference in intraoperative complications (p = 0.14), 90 day complication (p = 0.34), readmission rates (p = 0.425) or emergency room visits between groups (p = 0.15).

Conclusions: Despite higher medical comorbidities and increased rates of anticoagulation in octogenarians, there is no increase in operative or postoperative complication rates. Age alone should not be used as exclusion criteria for HoLEP.

Keywords: BPH; HoLEP; Octogenarian; Surgery.

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Comment in

  • Geriatrics.
    Griebling TL. Griebling TL. J Urol. 2023 Aug;210(2):362-365. doi: 10.1097/JU.0000000000003524. Epub 2023 May 9. J Urol. 2023. PMID: 37157786 No abstract available.

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