HoLEP Safe and Effective for Elderly Patients with Indwelling Catheters, Study Shows

The following were the key findings of the study:

• A total of 144 patients were included, with 71 in the ≥ 85 group and 73 in the control group. The median prostatic volume in the ≥ 85 and control groups was 90 mL and 90 mL, respectively.
• The median Charlson score for the ≥ 85 and control groups was 6 and 3, respectively.
• Postoperative major complication rates were 2% in the ≥ 85 group and 3% in the control group, with no significant difference.
• Transfusion rates were 11% in the ≥ 85 group and 9% in the control group, with no significant difference.
• The median length of stay was significantly longer in the ≥ 85 group (2 days) compared to the control group (1 day)).
• The rate of trial without catheter (TWOC) failure during hospitalization was significantly higher in the ≥ 85 groups (24%) compared to the control group (5%).
• At the 3-month follow-up, 0 patients in both groups had died, whereas at the 1-year follow-up, 14.1% of patients in the ≥ 85 group and 3% in the control group had died.
• One year after surgery, 97% of patients in the ≥ 85 group and 100% of patients in the control group could void spontaneously.

The findings revealed that HoLEP is a safe and effective procedure for elderly patients with indwelling catheters. One year post-surgery, 97% of patients regained the ability to void spontaneously, with a urinary incontinence rate of 11%. The one-year mortality rate was 14%, which is similar to the mortality rate observed in the general male population of the same age.

Reference:

Klein, C., Anract, J., Pinar, U. et al. Comparative study of HoLEP in elderly patients with indwelling catheters: a retrospective dual-center study. World J Urol 43, 75 (2025). https://doi.org/10.1007/s00345-024-05437-9