A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature

Abstract Objectives To evaluate the safety and efficacy of Holmium Laser Enucleation of the Prostate (HoLEP) in managing patients with a history of organ‐preserving treatments (OPT: Radiation Therapy – RT, High Intensity Focused Ultrasound ‐ HIFU) for Organ‐Confined Prostate Cancer (OC‐PCa). Methods...

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Main Authors: Renil S. Titus, Ansh Bhatia, Joao G. Porto, Jean C. Daher, Adele Raymo, Maggie Meyreles, Archan Khandekar, Aravindh Rathinam, Jonathan Katz, Robert Marcovich, Hemendra N. Shah
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:BJUI Compass
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Online Access:https://doi.org/10.1002/bco2.70061
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author Renil S. Titus
Ansh Bhatia
Joao G. Porto
Jean C. Daher
Adele Raymo
Maggie Meyreles
Archan Khandekar
Aravindh Rathinam
Jonathan Katz
Robert Marcovich
Hemendra N. Shah
author_facet Renil S. Titus
Ansh Bhatia
Joao G. Porto
Jean C. Daher
Adele Raymo
Maggie Meyreles
Archan Khandekar
Aravindh Rathinam
Jonathan Katz
Robert Marcovich
Hemendra N. Shah
author_sort Renil S. Titus
collection DOAJ
description Abstract Objectives To evaluate the safety and efficacy of Holmium Laser Enucleation of the Prostate (HoLEP) in managing patients with a history of organ‐preserving treatments (OPT: Radiation Therapy – RT, High Intensity Focused Ultrasound ‐ HIFU) for Organ‐Confined Prostate Cancer (OC‐PCa). Methods We reviewed men undergoing “en‐bloc” HoLEP between July 2017 and December 2023 from our institutional database to identify those with a history of OPT for OC‐PCa (study group). A 1:2 matched‐pair analysis was performed comparing these patients with a control group of men undergoing HoLEP for benign prostatic hyperplasia (BPH) without prior OPT. Demographic, perioperative and postoperative voiding parameters up to 1 year, as well as complications, were compared between groups. Unpaired t‐tests were used for parametric variables and Wilcoxon Rank tests for non‐parametric variables. A p‐value<0.05 was considered statistically significant. Results Of 660 patients, 15 had prior OPT before HoLEP. The time between OPT and HoLEP ranged from 3‐month to 12‐year. Associated urethral stricture and/or extensive prostatic calcification were present in five patients. Demographic and preoperative parameters were similar between the groups. However, the study group patient had significantly less resected tissue and higher rate of urinary incontinence at 3‐month. Two patients (13.3%) continued to experience incontinence at 1‐year. There was no clinically significant difference in postoperative improvement in voiding parameters amongst both groups. Conclusions HoLEP in patients with history of OPT for treatment of OC‐PCa is associated with a higher risk of transient urinary incontinence.
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spelling doaj-art-e3f8757a119940cfacd1e8bb7ca290042025-08-20T03:09:07ZengWileyBJUI Compass2688-45262025-07-0167n/an/a10.1002/bco2.70061A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literatureRenil S. Titus0Ansh Bhatia1Joao G. Porto2Jean C. Daher3Adele Raymo4Maggie Meyreles5Archan Khandekar6Aravindh Rathinam7Jonathan Katz8Robert Marcovich9Hemendra N. Shah10Houston Methodist Hospital Houston Texas USADepartment of Interventional Radiology University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USADesai Sethi Urology Institute University of Miami Miller School of Medicine Miami Florida USAAbstract Objectives To evaluate the safety and efficacy of Holmium Laser Enucleation of the Prostate (HoLEP) in managing patients with a history of organ‐preserving treatments (OPT: Radiation Therapy – RT, High Intensity Focused Ultrasound ‐ HIFU) for Organ‐Confined Prostate Cancer (OC‐PCa). Methods We reviewed men undergoing “en‐bloc” HoLEP between July 2017 and December 2023 from our institutional database to identify those with a history of OPT for OC‐PCa (study group). A 1:2 matched‐pair analysis was performed comparing these patients with a control group of men undergoing HoLEP for benign prostatic hyperplasia (BPH) without prior OPT. Demographic, perioperative and postoperative voiding parameters up to 1 year, as well as complications, were compared between groups. Unpaired t‐tests were used for parametric variables and Wilcoxon Rank tests for non‐parametric variables. A p‐value<0.05 was considered statistically significant. Results Of 660 patients, 15 had prior OPT before HoLEP. The time between OPT and HoLEP ranged from 3‐month to 12‐year. Associated urethral stricture and/or extensive prostatic calcification were present in five patients. Demographic and preoperative parameters were similar between the groups. However, the study group patient had significantly less resected tissue and higher rate of urinary incontinence at 3‐month. Two patients (13.3%) continued to experience incontinence at 1‐year. There was no clinically significant difference in postoperative improvement in voiding parameters amongst both groups. Conclusions HoLEP in patients with history of OPT for treatment of OC‐PCa is associated with a higher risk of transient urinary incontinence.https://doi.org/10.1002/bco2.70061bladder outlet obstructionBPHcomplicationsHIFUHoLEPprostate cancer
spellingShingle Renil S. Titus
Ansh Bhatia
Joao G. Porto
Jean C. Daher
Adele Raymo
Maggie Meyreles
Archan Khandekar
Aravindh Rathinam
Jonathan Katz
Robert Marcovich
Hemendra N. Shah
A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature
BJUI Compass
bladder outlet obstruction
BPH
complications
HIFU
HoLEP
prostate cancer
title A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature
title_full A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature
title_fullStr A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature
title_full_unstemmed A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature
title_short A pilot study evaluating the safety and efficacy of En‐bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature
title_sort pilot study evaluating the safety and efficacy of en bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature
topic bladder outlet obstruction
BPH
complications
HIFU
HoLEP
prostate cancer
url https://doi.org/10.1002/bco2.70061
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