Functional Outcomes After Holmium Laser Enucleation of the Prostate: Changes in the Urinary Flow Rate and Symptom Score During Short- and Mid-Term Follow-Up

OBJECTIVE: The objective of this study is to assess changes in the maximum urinary flow rate and symptom score in patients undergoing holmium laser enucleation of the prostate during short- and mid-term follow-up. MATERIALS AND METHODS: This retrospective longitudinal study included patients treated with holmium laser enucleation of the prostate between January 2021 and December 2022 at a tertiary referral center. The urinary flow rate and symptom score were evaluated before surgery and at 1, 3, 6, 12, 18, and 24 months after the procedure. Comparisons between baseline and postoperative values were performed using appropriate statistical tests, with statistical significance set at p < 0.05. RESULTS: The analysis included 121 patients with a mean age of 69.9 ± 8.0 years. The mean urinary flow rate increased from 10.29 ± 5.27 mL/s before surgery to 20.01 ± 10.94 mL/s at one month, with continued improvement reaching 25.83 ± 10.70 mL/s at 24 months. The mean symptom score decreased from 20.29 ± 9.25 at baseline to 9.12 ± 6.66 at one month, with further reduction to 5.65 ± 4.16 at 12 months. The overall postoperative complication rate was 13.9%, and urinary incontinence decreased from 7.4% in the early postoperative period to 0.8% at 12 months. CONCLUSIONS: In this cohort, holmium laser enucleation of the prostate was associated with sustained improvement in urinary flow and symptom burden, supporting its role as a durable surgical option for benign prostatic hyperplasia.