Efficacy of Holmium Laser Enucleation of the Prostate in Patients with a Small Prostate (≤ 30 mL)

Purpose: We investigated the effects of holmium laser enucleation of the prostate (HoLEP) in patients with a small prostate (<= 30 mL) in whom medical treatment was ineffective. Materials and Methods: Data from 132 patients who underwent HoLEP by a single surgeon between 2012 and 2015 were retrospectively analyzed. All patients received benign prostatic hyperplasia medication for at least 6 months before surgery. The patients were divided into 2 groups according to prostate size: group 1, <= 30 mL (n=30); and group 2, > 30 mL (n = 102). Clinical characteristics and the International Prostate Symptom Score (IPSS), including quality of life (QoL), peak urinary flow rate (Qmax), and postvoid residual urine (PVR), before surgery and 3 months postoperatively, were compared between the 2 groups. Results: In group 1, the IPSS, QoL, and PVR significantly decreased and the Qmax significantly increased 3 months after surgery. The voiding subscore also significantly decreased 3 months after surgery (p<0.001), but the storage subscore was not significantly different (p=0.055). In group 2, hemoglobin, the IPSS, QoL, and PVR significantly decreased and the Qmax significantly increased 3 months after surgery. In these patients, both the storage subscore and voiding subscore significantly decreased after surgery (both p<0.001). There were no significant differences between the groups in hemoglobin, IPSS, QoL, Qmax, and PVR either before or 3 months after surgery. Conclusions: When other medical treatments are ineffective, HoLEP is an effective intervention for patients with a small prostate.