Safety and Efficacy of Holmium Laser Enucleation of the Prostate (HoLEP) in Patients Requiring Anticoagulants/Antiplatelets: A Retrospective Study

Abstract

Objective:We evaluated Holmium Laser Enucleation of the Prostate (HoLEP) surgery performed in patients with benign prostatic obstruction (BPO) requiring anticoagulant/antiplatelet (AC/AP) therapy in terms of safety and efficacy.Materials and Methods:The retrospective data of 250 patients who underwent HoLEP between January 2020-May 2022 were included in the study. AC/AP treatment status’ of patients was recorded. The patients were divided into two groups as those requiring AC/AP (group 1, n=129) and those not using (group 2, n=121). Basic characteristics, preoperative and postoperative IPSS scores, Qmax and continence status’ at 1st and 6th month follow-up were recorded. Intra- and postoperative complications were recorded according to Clavien-Dindo classification.Results:No significant difference was observed between the groups in terms of preoeprative characteristics including prostate-specific antigen, hemoglobin (Hb), prostate volume, IPSS, Quality of Life score, Qmax, Qave and postvoiding residuel volume (p>0.05). There was no significant difference between the two groups in terms of postoperative functional parameters and urinary continence (p>0.05) and in Hb drop (0.13±0.1 g/dL vs. 0.08±0.15 g/dL, respectively; p=0.21). The blood transfusion rate was 2.3% in group 1 and 0.8% in group 2, and there was no significant difference between the groups (p=0.62). Additionally, there was no significant difference between the groups regarding complications.Conclusion:HoLEP is a safe and effective, minimally invasive surgical method that improves functional parameters in BPO patients requiring AC/AP.

Keywords

• anticoagulant
• bleeding
• holep
• safety