Holmium laser enucleation of the prostate: a 3-year single-center experience of 173 cases

African Journal of Urology

Table 3 Intra and postoperative complications

Intraoperative complications*
Capsular perforation	21 (12.1)
Bladder trigone detachment	4 (2.3)
Superficial bladder mucosal injury	3 (1.7)
Conversion
Morcellator device malfunction	2 (1.1)
High density of enucleated prostatic tissue	4 (2.3)
Lateral lobules adherent to the prostatic capsular	2 (1.1)
Prostate cavity hemostasis	3 (1.7)
Bulky prostatic tissue retrieved by cystotomy	1 (0.6)
Early postoperative complications*
Postoperative Hematuria with clot retention	29 (16.8)
Blood transfusion	6 (3.5)
Extraperitoneal extravasation of irrigation liquid	1 (0.6)
Infectious complications
Prostatitis	8 (4.6)
Orchiepididymitis	3 (1.7)
Stroke	1 (0.6)
Late postoperative complications
Persistent urinary incontinence**	13 (7.5)
Urethral stricture	2 (1.1)
Bladder neck sclerosis	4 (2.3)
Ventral penile curvature	1 (0.6)
Reoperation***	6 (3.5)

*Intra and early postoperative complications occurred within 01 month following Holep, while late postoperative complications occurred after 01 month
**Transient urinary incontinence within 03 months post Holep was observed in 23 patients (13.3%) whereas persistent urinary incontinence at 6 and 12 months following Holep was observed in in 11 (6.4%) and 06 (3.5%) patients, respectively. Stress urinary incontinence was the most predominant type: 17 (9.9%), 08 (4.6%) and 4 (2.3%) patients at 3, 6 and 12 months, respectively
***Reoperation included Holep enucleation for remaining lateral lobes 3 months following median lobe enucleation (01 patient, 0.6%), residual prostatic tissue obstructing the membranous urethra (01 patient, 0.6%), recurrent BPH at 24 and 41 months treated by TURP (2 patients, 1.2%) and suburethral sling surgery (2 patients, 1.2%)