Volume 17, Issue 2 e70010

ORIGINAL ARTICLE

Retrospective Comparison of Postoperative Outcomes Between Elderly and Non-Elderly Patients With Benign Prostatic Enlargement Using Holmium Laser Enucleation and Transurethral Vaporization of the Prostate at Multiple High-Volume Centers

Hiroki Ito,

Corresponding Author

Hiroki Ito

[email protected]

orcid.org/0000-0002-4433-370X

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan

Correspondence:

Hiroki Ito ([email protected])

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Takuma Nirei,

Takuma Nirei

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Takeshi Fukazawa,

Takeshi Fukazawa

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Hiroki Takizawa,

Hiroki Takizawa

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Mari Hioki,

Mari Hioki

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Risa Shinoki,

Risa Shinoki

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Yutaro Hayashi,

Yutaro Hayashi

Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan

Department of Urology, International Goodwill Hospital, Yokohama, Kanagawa, Japan

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Takashi Kawahara,

Takashi Kawahara

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Shuko Yoneyama,

Shuko Yoneyama

Department of Urology, International Goodwill Hospital, Yokohama, Kanagawa, Japan

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Kazuhide Makiyama,

Kazuhide Makiyama

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Akitoshi Takizawa,

Akitoshi Takizawa

Department of Urology, International Goodwill Hospital, Yokohama, Kanagawa, Japan

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Kazuki Kobayashi,

Kazuki Kobayashi

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Hiroki Ito,

Corresponding Author

Hiroki Ito

[email protected]

orcid.org/0000-0002-4433-370X

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan

Correspondence:

Hiroki Ito ([email protected])

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Takuma Nirei,

Takuma Nirei

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Takeshi Fukazawa,

Takeshi Fukazawa

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Hiroki Takizawa,

Hiroki Takizawa

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Mari Hioki,

Mari Hioki

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Risa Shinoki,

Risa Shinoki

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Yutaro Hayashi,

Yutaro Hayashi

Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan

Department of Urology, International Goodwill Hospital, Yokohama, Kanagawa, Japan

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Takashi Kawahara,

Takashi Kawahara

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Shuko Yoneyama,

Shuko Yoneyama

Department of Urology, International Goodwill Hospital, Yokohama, Kanagawa, Japan

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Kazuhide Makiyama,

Kazuhide Makiyama

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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Akitoshi Takizawa,

Akitoshi Takizawa

Department of Urology, International Goodwill Hospital, Yokohama, Kanagawa, Japan

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Kazuki Kobayashi,

Kazuki Kobayashi

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

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First published: 04 March 2025

https://doi.org/10.1111/luts.70010

Funding: The authors received no specific funding for this work.

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ABSTRACT

Objectives

This retrospective study aimed to compare the surgical outcomes of holmium laser enucleation of the prostate (HoLEP) and transurethral vaporization techniques between the elderly and nonelderly patients with benign prostatic enlargement (BPE).

Methods

We retrospectively analyzed clinical data from two regional centers that used HoLEP and transurethral vaporization techniques for BPE treatment. The study population consisted of male patients with lower urinary tract symptoms, divided into elderly and nonelderly groups.

Results

Total 477 of 872 patients remained in the study, of which 198 were classified as elderly (age ≥ 75 years) and 279 as non-elderly (age < 75 years). The postoperative decrease in IPSS was significantly lower in the elderly group, and advanced age was associated with less IPSS decline only after vaporization (p = 0.003) but not after HoLEP. In both surgeries, the duration of postoperative catheterization was significantly longer in the elderly group than in the non-elderly group, and hemoglobin drop at 1 day postoperatively showed no age-related difference. The most common complication after HoLEP was intermittent incontinence, which was more frequent in the elderly group (15.0%) than in the non-elderly group (6.2%, p = 0.038). Regardless of age, the overall rate of need for medication at 6 months postoperatively was significantly higher after HoLEP (32/190, 16.8%) than after transurethral vaporization (30/287, 10.5%) (p = 0.042). The need for medication was higher in the elderly for both HoLEP and vaporization than in the non-elderly group with a specific cutoff of age.

Conclusions

Elderly patients with BPE had relatively worse surgical outcomes, including a higher need for postoperative medications and prolonged catheterization. HoLEP demonstrated a reduction in IPSS regardless of age, and transurethral vaporization did not, although it was associated with a higher rate of intermittent incontinence.

Conflicts of Interest

The authors declare no conflicts of interest.

Open Research

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Volume17, Issue2

March 2025

e70010

Retrospective Comparison of Postoperative Outcomes Between Elderly and Non-Elderly Patients With Benign Prostatic Enlargement Using Holmium Laser Enucleation and Transurethral Vaporization of the Prostate at Multiple High-Volume Centers

ABSTRACT

Objectives

Methods

Results

Conclusions

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Information

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Retrospective Comparison of Postoperative Outcomes Between Elderly and Non-Elderly Patients With Benign Prostatic Enlargement Using Holmium Laser Enucleation and Transurethral Vaporization of the Prostate at Multiple High-Volume Centers

ABSTRACT

Objectives

Methods

Results

Conclusions

Conflicts of Interest

Open Research

Data Availability Statement

References

References

Related

Information