The Effects of Holmium Laser Enucleation of the Prostate (HoLEP) on Urodynamic Parameters and Bladder Function: A Retrospective Analysis

Authors : Yunus Çolakoğlu, Çağrı Şevik, Emre Korkmaz, Metin Savun, Abdülmüttalip Şimşek
Pages : 139-146
Doi:10.54233/endourolbull-1721693
View : 30 | Download : 39
Publication Date : 2025-09-30
Article Type : Research Paper
Abstract :Objective: This study evaluates the impact of Holmium Laser Enucleation of the Prostate (HoLEP) on urodynamic parameters and bladder function in patients with benign prostatic hyperplasia (BPH). Material And Methods: A retrospective analysis was conducted on 44 patients with urodynamically confirmed BPH who underwent HoLEP in a tertiary care center. Preoperative and 6-month postoperative assessments included the International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual (PVR) volume, and urodynamic studies measuring detrusor pressure, maximum flow rate (Qmax), bladder outlet obstruction index (BOOI), and detrusor overactivity (DO). Statistical comparisons were conducted using paired t-tests, Wilcoxon signed-rank tests, and McNemar’s test. Results: Significant improvements were observed post-HoLEP, including a reduction in IPSS (22.0 ± 7.0 to 6.1 ± 5.0, p<0.001), daytime frequency (7.4 ± 1.5 to 5.8 ± 1.2, p=0.01), nocturia (3.2 ± 0.8 to 1.1 ± 0.5, p<0.001), and PVR (175.0 ± 50.0 to 45.4 ± 15.0 mL, p<0.001). Qmax increased from 6.8 ± 2.0 to 19.7 ± 4.5 mL/s (p<0.001), maximum bladder capacity from 180.0 ± 45.0 to 375.0 ± 75.0 mL (p<0.001), and maximum cystometric capacity from 280.0 ± 56.0 to 415.0 ± 83.0 mL (p<0.001). BOOI decreased from 75.9 ± 15.0 to-8.5 ± 5.0 (p<0.001). Poor bladder compliance and DO prevalence decreased (13.6% to 6.8%, p=0.30; 25.0% to 11.3%, p=0.10), though not statistically significant. Conclusion: HoLEP significantly improves urodynamic parameters and bladder function in BPH patients, particularly in those with complex urodynamic profiles. These findings support HoLEP as an effective treatment for relieving bladder outlet obstruction and improving lower urinary tract symptoms, with potential benefits for detrusor overactivity and bladder compliance.
Keywords : alt üriner sistem semptomları, BPH, HoLEP, ürodinamik parametre

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