[Holmium laser enucleation of the prostate: the Kobe City General Hospital experience].

Between October 2004 and August 2005, 43 patients with the mean age of 70.9 (ranging 57-83) years, who had lower urinary tract symptoms underwent holmium laser enucleation of the prostate (HoLEP) at our hospital. The mean operative time, change in hemoglobin and resected tissue weight were 193 (83-390) minutes, -2.1 (-5.3 -/+ 1.3) g/dl and 40.2 (6.3-90.9) g, respectively. The mean postoperative urethral catheter time and postoperative hospital stay were 1.7 and 5.5 days, respectively. Minor prostatic capsular perforation and bladder mucosal injuries in 18 cases without need of additional interventions or treatments. Blood transfusion for preoperative anemia was needed in one case. Postoperatively, high fever occurred in 6 cases including sepsis in one case, while recatheterization was needed in 2 cases because of urination difficulty. After discharge, meatal stenosis was found in 7 cases, urethral stenosis in 3 cases including 2 cases with preoperative urethral stenosis. Scrotal abscess developed after acute epididymitis in one case. Transient urinary incontinence reported in 12 cases, which requires medication or more than 1 pad per day. HoLEP improved international prostate symptom score, quality of life score, peak urinary flow rates and postvoiding residual urine volumes immediately and significantly. HoLEP is a feasible and effective procedure to relieve lower urinary tract symptoms, although technical and instrumental advances are required to reduce the operative time and complications.