Holmium Laser Resection of the Prostate

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Abstract
A total of 35 patients with benign prostatic hyperplasia (BPH) were treated with the Ho:YAG laser using a new technique termed holmium laser resection of the prostate or HoLRP. The laser energy was applied directly to prostatic tissue exclusively through the use of a standard 550-μm end-firing fiber. A high-powered holmium laser was used and was set at 2.4 J per pulse at 25 pulses per second for an average power of 60 W. The mean preoperative AUA Symptom Score was 24. Postoperatively, the score dropped to 10.9, 8.2, 5.2, and 4.6 at 1 week, 1 month, 3 months, and 6 months, respectively. The peak urine flow rate improved from 6.3 mL/sec preoperatively to 15.1, 15.3, 15.5, and 16 mL/sec at 1 week, 1 month, 3 months, and 6 months. A Foley catheter was removed within 24 hours of completion of the operation in 31 patients (89%), and voiding was improved. The HoLRP technique was bloodless, and the short-term results were satisfactory. Most importantly, the defect produced by HoLRP is identical to that of a conventional transurethral resection. These initial results demonstrate that HoLRP is a useful surgical alternative in the treatment of patients with obstructive BPH.