Preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate

Abstract

Background: To evaluate preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate (HoLEP) Methods: We enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc ‘no-touch’ HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times. Result: The average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of antiplatelet agents, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight. Conclusion: En bloc ‘no-touch’ HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and antiplatelet agents were correlated with increased operative time.