Brendan Browne, MD, on patient selection for HoLEP for BPH

In this video, Brendan M. Browne, MD, discusses which patients may be best suited to undergo HoLEP for benign prostatic hyperplasia (BPH). Browne is an assistant professor of urology at Emory University School of Medicine in Atlanta, Georgia.

Video Transcript:

In terms of patient selection for HoLEP, there are a lot of patients who may benefit from that. The patients I find that have the most pronounced benefit are the patients with the very large prostates, or the patients who are catheter dependent with concern for neurogenic or myogenic bladder failure. Clearing out the prostatic urethra to reduce the resistance of urine exiting the bladder as much as you can in those catheter dependent patients, I think provides a large benefit for their long-term success. There are certainly other factors that come into it, whether you want to treat a bladder stone at the same time and you can use your laser, or if they've had lots of intra-abdominal surgery and maybe a simple prostatectomy, robotic simple or even single-port. Transvesical simple prostatectomy may prove challenging. That certainly has the benefits for HoLEP.

There are patients where it's not really a great idea. The biggest one that comes to mind is patients with urethral strictures where you may have a scope across that stricture for longer than you may desire, and it's a larger caliber scope and may exacerbate their stricture, and then you're just trading one obstruction for another.

This transcript was AI generated and edited by human editors for clarity.