Our clinic's first experience with HoLEP

Initial experience with holmium laser enucleation of the prostate in a urology specialist hospital in Nigeria

Background

Holmium laser enucleation of the prostate (HoLEP) is a more recent procedure for the management of Benign Prostatic Hyperplasia compared to open prostatectomy or Transurethral Resection of the Prostate. HoLEP is not commonly done in Nigeria. The objective of the study was to determine whether our initial experience with HoLEP in Abuja, favourably compared to those of other centres across the world.

Methods

A retrospective study was done on 40 patients who had HoLEP between October 2018 and December 2019. Pre- and post-operative International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), prostate sizes, maximum flow rate (Qmax) and post-void residual urine volume (PVR) were collated. The duration of irrigation, catheterization and length of hospital stay were also recorded and analysed. Complications were documented.

Results

There were improvements in IPSS from 19.67 to 5.41, PSA from 8.07 to 2.03 ng/ml,Qmax from 11.27 to 29.67 ml/min, PVR from 88.99 to 32.8 ml, while average prostate sizes reduced from 116.54 to 30.3 g after surgery. Following HoLEP, the duration of irrigation was 18.00 h, catheterization was 26.76 h and length of hospital stay was 1.82 days. Two (5.0%) patients were recatheterized, 4 (10.0%) developed post-operative bladder neck stenosis.

Conclusions

The outcome of HoLEP in our experience compared favourably with those from other centres. With adequate training and requisite equipment in resource-poor environments, technical procedures like HoLEP can be embarked on with favourable results.