Understanding holmium laser enucleation of the prostate (HoLEP) recovery: Assessing patient expectations and understanding

Authors

  • Mark A. Assmus Indiana University School of Medicine, Department of Urology, Indianapolis, Indiana http://orcid.org/0000-0003-3615-9251
  • Matt S. Lee Northwestern University, Department of Urology, Chicago, Illinois
  • Tim Large Indiana University School of Medicine, Department of Urology, Indianapolis, Indiana
  • Amy E. Krambeck Northwestern University, Department of Urology, Chicago, Illinois

DOI:

https://doi.org/10.5489/cuaj.7328

Keywords:

HoLEP, Quality Assessment, Patient Reported Outcome

Abstract

Introduction: Although holmium laser enucleation of the prostate (HoLEP) is a highly effective surgery, there is a variable recovery period where patients may experience hematuria, dysuria, or urinary incontinence (UI). Despite preoperative consultation, there is a paucity of literature examining the effectiveness of physician-patient communication in preparing the patient for the postoperative recovery period. We sought to examine recovery expectations as a patient-reported outcome (PRO) metric for HoLEP.

Methods: With institutional review board approval, we queried our electronic medical record and retrospective clinical registry to identify 50 consecutive patients that underwent HoLEP from November 2019 to March 2020 by two endourologists. Patients were provided questionnaires via Twistle© ≥6 months postoperatively. Patient demographics and perioperative course was examined in the context of responses. Our primary objective was determining whether patients felt they had a reasonable understanding of the recovery process.

Results: We observed a 92% (46/50) response rate, with an average patient age of 69.4 years (range 55–88). Overall, 91.3% (42/46) felt they had a reasonable understanding of the recovery. Additionally, 97.8% (45/46) were aware of temporary UI, with 87% having ≥1 episodes of UI after catheter removal. We found 47.8% (22/46) of patients expected UI to resolve within 30 days, while 8.6% expected >90 days of UI. All patients were aware of the risk of hematuria, with 93.5% (43/46) expecting resolution within 30 days (<7 days: 47.8%; 7–14 days: 28.3%; 15–30 days: 17.4%).

Conclusions: Although surgical technique continues to improve HoLEP, ensuring adequate physician-patient communication to optimize expectations is crucial. We report patient understanding of HoLEP recovery and areas for future improvement.

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Published

2021-08-26

How to Cite

Assmus, M. A., Lee, M. . S., Large, T., & Krambeck, A. (2021). Understanding holmium laser enucleation of the prostate (HoLEP) recovery: Assessing patient expectations and understanding. Canadian Urological Association Journal, 16(1). https://doi.org/10.5489/cuaj.7328

Issue

Section

Original Research