Initial Experience with Holmium Laser Enucleation of the Prostate (HoLEP) in Nigeria.

Abstract

Introduction: Holmium Laser Enucleation of the Prostate (HoLEP) was introduced to address some of the limitations of TURP. HoLEP is not common in Africa, despite its advantages. The objective of this study is to analyse the Nigerian experience with HoLEP in comparison with those of other centres in order to stimulate interest in a shift to this procedure in our environment. Methods: Twenty nine patients have had HoLEP in Kelina Hospital, Abuja since October 2018. Indications for surgery ranged from failed medical treatment, urinary retention to hematuria. Preoperative assessment of IPSS, QoL, Prostate size, Residual volume and Qmax was done. Six patients had be encatheterized prior to presentation and did not have Qmax or Residual volumes computed. Two had urethral injuries elsewhere prior to surgery. HoLEP was done with the Lumenis 120W laser, Moses Technology™. All except one patient had bladder irrigation post-surgery. The duration of irrigation, catheterization and hospital stay was computed. Results: The average age of patients was 68.30±8.95 years. Prostatic volume was 107.37g±64.4g. PSA was 12.51±20.51 ng/ml. Irrigation time was 20.46±16.19hrs. Mean catheterization time was 1.3days. Hospital stay was 1.96±1.09 days. Two patients were discharged home on catheter on account of pre-operative urethral injuries. Four patients were transfused pre and intra-op on account of low hematocrit. Conclusion: The results are comparable to those of other centers who have done HoLEP for years and are reproducible even in resource poor, manpower-deficient settings like ours.