Safety and feasibility of concomitant surgery during holmium laser enucleation of the prostate (HoLEP)

Amar Patel, Rafael Nunez, Chinedu O. Mmeje, Mitchell R. Humphreys

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To determine the feasibility and outcomes associated with performing simultaneous surgical procedures during holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia and concomitant urologic conditions.

Results: A total of 372 HoLEPs were performed. Thirty-eight (10.2 %) patients underwent concomitant procedures at the time of HoLEP. Compared to the simple and intermediate secondary surgical procedures, the matched control group that underwent a HoLEP alone did not demonstrate statistically significant differences in the preoperative, operative, or postoperative outcomes. Patients with a complex secondary surgical procedure at the time of HoLEP had statistically significant differences in operative time (221 vs. 65 min, p = 0.007), estimated blood loss (92 vs. 33 mL, p = 0.012), catheter time (8.5 vs. 1 day, p = 0.041), and length of hospitalization (2 vs. 1 day, p = 0.032) compared to the control group.

Conclusions: Obstructive voiding symptoms secondary to BPH are common in older patients and may coincide with other concomitant lower urinary tract pathology that may require surgical intervention. Rather than staging surgical interventions, it appears that definitive treatment for BPH with HoLEP is safe and efficacious in those patients that also require secondary procedures.

Methods: A retrospective review of patients that underwent a HoLEP was performed. Patients undergoing a concomitant procedure at the time of HoLEP were selected and stratified based on complexity of the secondary procedure (simple, intermediate, and complex) and matched based on age and prostate volume to patients undergoing only a HoLEP. Baseline characteristics, preoperative, operative, and postoperative outcomes were collected.

Original languageEnglish (US)
Pages (from-to)1543-1549
Number of pages7
JournalWorld Journal of Urology
Issue number6
StatePublished - Nov 19 2014


  • BPH
  • Concomitant procedure
  • Holmium laser enucleation of the prostate
  • Simultaneous surgery

ASJC Scopus subject areas

  • Urology


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