Same-day trial of void and discharge following standard vs. MOSESTM holmium laser enucleation of the prostate

A single-center experience

Authors

  • Yasser Noureldin
  • Aurinjoy Gupta
  • Amr Hodhod
  • Ahmed S. Zakaria
  • Ruba Abdul Hadi
  • Vahid Mehrnoush
  • Loay Abbas
  • Moustafa Fathy
  • Amer Alaref
  • Ahmed Kotb
  • Walid Shahrour
  • Hazem Elmansy

DOI:

https://doi.org/10.5489/cuaj.7983

Keywords:

Benign Prostatic Hyperplesia, Laser, Enucleation

Abstract

Introduction: We aimed to compare perioperative and postoperative outcomes and to assess the safety and feasibility of same-day trial of void (TOV) in patients who underwent standard holmium laser enucleation of the prostate (HoLEP) vs. MOSESTM HoLEP (MoLEP).

Methods: We conducted a retrospective review of prospectively collected data of patients that underwent HoLEP (100 W) or MoLEP (120 W) with same-day catheter removal three hours postoperatively at our institution from August 2018 to September 2021. Patient demographics, intraoperative parameters, and postoperative outcomes were analyzed. Data were compared as means with standard deviation and medians with interquartile range (IQR) or numbers and percentages. Continuous and categorical variables were assessed using the Mann-Whitney U test and Chi-squared test, respectively. Predictors of shorter enucleation time and failed same-day TOV were investigated.

Results: Of the 90 patients included, 28 underwent HoLEP while 62 had MoLEP. There was no significant difference between the groups in terms of the successful TOV (23 [82%] vs. 58 [93.5%], p=0.1) and readmission rate (3 [10.7%] vs. 1 [1.6%], p=0.08); however, the MoLEP group had a significantly shorter mean enucleation time (p<0.001), mean hemostasis time (p<0.001), mean morcellation time (p=0.003), and lower mean energy used (p<0.001). On the logistic regression model, MoLEP (odds ratio [OR] 0.03, 95% confidence interval [CI] 0.007–0.19, p<0.001), lower preoperative prostate-specific antigen (PSA) test (OR 1.25, 95% CI 1.01–1.55, p=0.03), and smaller prostate size (OR 1.06, 95% CI 1.02–1.09, p<0.001) were independent predictors of shorter enucleation time. History of preoperative retention was the only significant factor associated with a failed same-day TOV (p=0.04). There was no difference in intraoperative or postoperative complication rates or postoperative functional outcomes between the two technologies.

Conclusions: Same-day TOV and discharge are feasible following standard HoLEP and MoLEP, with comparable outcomes; however, the use of MOSESTM technology offered better enucleation efficiency with excellent hemostatic potential. Preoperative retention was the only predictor of failed same-day TOV.

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Published

2022-08-30

How to Cite

Noureldin, Y., Gupta, A., Hodhod, A., Zakaria, A. S. ., Abdul Hadi, R. ., Mehrnoush, V. ., Abbas, L., Fathy, M., Alaref, A., Kotb, A., Shahrour, W. ., & Elmansy, H. (2022). Same-day trial of void and discharge following standard vs. MOSESTM holmium laser enucleation of the prostate : A single-center experience. Canadian Urological Association Journal, 17(1), E23–8. https://doi.org/10.5489/cuaj.7983

Issue

Vol. 17 No. 1 (2023): CUAJ January

Section

Original Research

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