Research fellow Baylor Scott & White Health; Alexandria University Faculty of Medicine, Egypt
Introduction: With the growing population aging, BPH burden has increased with considerable percentage of octogenarian (80-90 years) and nonagenarian (>90 years) patients requiring surgical management. We aimed to assess the difference in complication rate and functional outcome of Holmium laser enucleation of prostate (HoLEP) in these age groups. Methods: Maintained database was reviewed for HoLEP patients with follow up of 1 year. Patients were divided into 2 groups according to age: = 80 years (G I) and < 80 years (G II). Perioperative complications and functional outcomes were compared between both groups. Results: Total 1090 patients were included, 201 and 889 in GI and II respectively. Median age was 84 and 70 years in GI and GII respectively. GI had significantly higher frailty score, lower baseline hemoglobin and more anticoagulant use. GI showed significantly longer operative time, higher rate of blood transfusion, longer catheterization time and higher rates of failed 1st voiding trial, emergency room (ER) visits and readmission. Clavien-Dindo complications within 30-days were statistically higher in GI (20.8% vs 9.3%, p= 0.008) although over-grade II complications were comparable in both groups (3.4% vs 1.79%, p= 0.133). [Tables 1,2] Follow up IPSS and incontinence rates were comparable in both groups. [Figure 1] Conclusions: HoLEP is a safe and very effective option in the geriatric population of octogenarians and nonagenarians. HoLEP is associated with higher overall complication rate in octogenarians and nonagenarians, however most complications are minor with comparable over-grade II complication rate to younger age group. SOURCE OF Funding: None
