KẾT QUẢ PHẪU THUẬT BÓC NHÂN PHÌ ĐẠI LÀNH TÍNH TUYẾN TIỀN LIỆT BẰNG HOLMIUM LASER QUA ĐƯỜNG NIỆU ĐẠO TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC GIAI ĐOẠN 2022 – 2024

Abstract

Objective: To evaluate the outcomes and safety of en bloc holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH). Additionally, we aimed to predict enucleation time based on preoperative prostate volume. Subjects and Methods: We conducted a retrospective study on 203 patients who underwent HoLEP for BPH from January 2022 to December 2024. The en bloc enucleation technique was performed through an incision at the 12 o’clock position. Intraoperative parameters included enucleation time, morcellation time, weight of morcellated tissue, estimated blood loss, and intraoperative complications. Postoperative parameters included duration of urethral catheterization, length of hospital stay, voiding status, and complications classified according to the Clavien–Dindo grading system. Patients were evaluated at the time of the study. Results: A total of 203 patients underwent HoLEP, with a mean age of 72.38 ± 8.83 years. The mean operative time was 70.56 minutes, and the average catheterization duration was 4.72 days. Postoperative hemoglobin, hematocrit, serum sodium, and potassium levels showed statistically significant reductions (p < 0.001), although sodium levels remained within physiological limits. The complication rate was low, with significant improvements in IPSS and QoL scores postoperatively (p < 0.001). The surface area of the enucleated adenoma (S) correlated more strongly with enucleation time (T) than prostate mass (M), with the regression equation: T = 17.320 + 0.225 × S. Conclusion: En bloc HoLEP is a safe, feasible, and effective surgical procedure for BPH regardless of prostate size. Enucleation time can be predicted based on preoperative prostate volume.