[Holmium laser enucleation of the prostate as a day case surgery: prospective evaluation of the first 30 patients]. / Énucléation de la prostate au laser Holmium en chirurgie ambulatoire : évaluation prospective des 30 premiers patients.

ABSTRACT

OBJECTIVES: To evaluate the feasibility of holmium laser enucleation of the prostate (HoLEP) as a day case surgery. MATERIAL AND METHODS: Observational prospective study including 30 consecutive patients after exclusion of unstable diseases and anticoagulant therapy. Patients were discharged before 8PM and the urinary catheter was removed at home the next morning. The monitoring included a phone call after 24hours and clinical evaluations after 1 and 3month follow-up. Clinical data were prospectively collected and complications were classified according to the Clavien-Dindo classification. RESULTS: The mean age of the study population was 63.8, prostate volume was 75.3cc, maximum urinary flow rate was 9.5mL/s, and IPSS was 22.9. The conversion rate to conventional hospitalization was 3.3%. After 3months follow-up, readmission and reoperation rates were respectively 16.6% and 3.3%. The overall complication rate was 66% (Clavien I=57.7%, II=38.5%, III=3.8%). The satisfaction rate was 100% (score=9.2/10). The mean prostate volume at 3months follow-up was 23.3cc, maximum urinary flow was 25.6mL/s, and IPSS was 4.7. CONCLUSION: This study confirmed the feasibility of HoLEP as a day case surgery for selected patients. Conversion rate to conventional hospitalization and complications of grade >2 were less than 5% while the satisfaction rate was high. LEVEL OF EVIDENCE 3.