¿Resuelve el HoLEP la insuficiencia renal obstructiva prostática?

Carla Casanova García; Roger  Freixa Sala; Marco Franco; Carlos  Gasanz Serrano; Jordi Cervera Alcaide; Joan  Areal Calama; Fernando Agreda Castañeda

doi:10.48204/medica.v45n2.8404

Submitted October 8, 2025

Published 2025-10-14

Artículos originales

Vol. 45 No. 2 (2025): Revista médica de Panamá

Does HoLEP resolve prostatic obstructive renal failure?

Carla Casanova García⁺⁻
Roger Freixa Sala⁺⁻
Marco Franco⁺⁻
Carlos Gasanz Serrano⁺⁻
Jordi Cervera Alcaide⁺⁻
Joan Areal Calama⁺⁻
Fernando Agreda Castañeda ⁺⁻

DOI https://doi.org/10.48204/medica.v45n2.8404

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DOI: 10.48204/medica.v45n2.8404

Published: 2025-10-14

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Casanova García, C., Freixa Sala, R., Franco, M., Gasanz Serrano, C., Cervera Alcaide, J., Areal Calama, J., & Agreda Castañeda , F. (2025). Does HoLEP resolve prostatic obstructive renal failure?. Revista médica De Panamá, 45(2), 33–38. https://doi.org/10.48204/medica.v45n2.8404

Abstract

Introduction: in patients with benign prostatic enlargement, obstructive renal failure (ORF) is a common complication, and holmium laser enucleation of the prostate (HoLEP) is the treatment of choice. However, limited data is available on the evolution of urodynamic and renal function parameters in these patients. Our objective is to evaluate the effect of HoLEP on urodynamic and renal function parameters in this patient population.

Materials and Methods: in the Germans Trias i Pujol Hospital (Barcelona, España) a retrospective study was conducted on all patients with suspected ORF (those with an indwelling urinary catheter) who underwent HoLEP between 2017 and 2022. Two groups were defined for analysis: patients without ORF and those diagnosed with ORF at the time of evaluation. Demographic, surgical, renal function, and urodynamic data were collected before and after surgery.

Results: a total of 163 patients were included; 131 without ORF and 32 with ORF. No significant differences were observed in clinical, surgical, or urodynamic variables between the two groups. Patients with ORF had higher creatinine levels and a lower glomerular filtration rate before surgery. After surgery, ORF patients exhibited normal urodynamic and renal function parameters.

Conclusions: HoLEP is an effective treatment for patients with prostatic obstruction. In patients with ORF, the procedure restores renal function and urodynamic parameters to normal levels.

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References

P. Abrams et al., The standardization of terminology of lower urinary tract function: Report from the standardization sub?committee of the International Continence Society, Neurourol. Urodyn., vol. 21, n.o 2, pp. 167-178, mar. 2002, doi: 10.1002/nau.10052.
C. Gratzke et al., «EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction», Eur. Urol., vol. 67, n.o 6, pp. 1099-1109, jun. 2015, doi: 10.1016/j.eururo.2014.12.038.
C.-H. Lu et al., Is intravesical prostatic protrusion a risk factor for hydronephrosis and renal insufficiency in benign prostate hyperplasia patients?», J. Chin. Med. Assoc., vol. 82, n.o 5, pp. 381-384, May 2019, doi: 10.1097/JCMA.0000000000000088.
C. L. A. Negro y G. H. Muir, «Chronic urinary retention in men: How we define it, and how does it affect treatment outcome», BJU Int., vol. 110, n.o 11, pp. 1590-1594, dic. 2012, doi: 10.1111/j.1464-410X.2012.11101.x.
T. Aho, W. Finch, P. Jefferson, L. Suraparaju, y F. Georgiades, HoLEP for acute and non-neurogenic chronic urinary retention: how effective is it?», World J. Urol., vol. 39, n.o 7, pp. 2355-2361, Jul. 2021, doi: 10.1007/s00345-021-03657-x.
F. Agreda Castañeda, ó. Buisan Rueda, y J. J. Areal Calama, «Análisis de las complicaciones en el aprendizaje del HoLEP: revisión sistemática», Actas Urol. Esp., vol. 44, n.o 1, pp. 1-8, Ene. 2020, doi: 10.1016/j.acuro.2019.08.008.
G. Saitta et al., «‘En Bloc’ HoLEP with early apical release in men with benign prostatic hyperplasia», World J. Urol., vol. 37, n.o 11, pp. 2451-2458, nov. 2019, doi: 10.1007/s00345-019-02671-4.
G. Geirsson, M. Fall, y S. Lindstrom, «The Ice?water Test—A Simple and Valuable Supplement to Routine Cytometry», Br. J. Urol., vol. 71, n.o 6, pp. 681-685, jun. 1993, doi: 10.1111/j.1464-410X.1993.tb16065.x.
M. Emberton et al., «The National Prostatectomy Audit: the clinical management of patients during hospital admission», Br. J. Urol., vol. 75, n.o 3, pp. 301-316, mar. 1995, doi: 10.1111/j.1464-410X.1995.tb07341.x.
J. L. Donovan et al., «A randomized trial comparing transurethral resection of the prostate, laser therapy and conservative treatment of men with symptoms associated with benign prostatic enlargement: The CLasP study», J. Urol., vol. 164, n.o 1, pp. 65-70, jul. 2000.
B. Djavan, S. Madersbacher, C. Klingler, y M. Marberger, URODYNAMIC ASSESSMENT OF PATIENTS WITH ACUTE URINARY RETENTION: IS TREATMENT FAILURE AFTER PROSTATECTOMY PREDICTABLE?», J. Urol., vol. 158, n.o 5, pp. 1829-1833, nov. 1997, doi: 10.1016/S0022-5347(01)64139-9.

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[1] P. Abrams et al., The standardization of terminology of lower urinary tract function: Report from the standardization sub?committee of the International Continence Society, Neurourol. Urodyn., vol. 21, n.o 2, pp. 167-178, mar. 2002, doi: 10.1002/nau.10052.

[2] C. Gratzke et al., «EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction», Eur. Urol., vol. 67, n.o 6, pp. 1099-1109, jun. 2015, doi: 10.1016/j.eururo.2014.12.038.

[3] C.-H. Lu et al., Is intravesical prostatic protrusion a risk factor for hydronephrosis and renal insufficiency in benign prostate hyperplasia patients?», J. Chin. Med. Assoc., vol. 82, n.o 5, pp. 381-384, May 2019, doi: 10.1097/JCMA.0000000000000088.

[4] C. L. A. Negro y G. H. Muir, «Chronic urinary retention in men: How we define it, and how does it affect treatment outcome», BJU Int., vol. 110, n.o 11, pp. 1590-1594, dic. 2012, doi: 10.1111/j.1464-410X.2012.11101.x.

[5] T. Aho, W. Finch, P. Jefferson, L. Suraparaju, y F. Georgiades, HoLEP for acute and non-neurogenic chronic urinary retention: how effective is it?», World J. Urol., vol. 39, n.o 7, pp. 2355-2361, Jul. 2021, doi: 10.1007/s00345-021-03657-x.

[6] F. Agreda Castañeda, ó. Buisan Rueda, y J. J. Areal Calama, «Análisis de las complicaciones en el aprendizaje del HoLEP: revisión sistemática», Actas Urol. Esp., vol. 44, n.o 1, pp. 1-8, Ene. 2020, doi: 10.1016/j.acuro.2019.08.008.

[7] G. Saitta et al., «‘En Bloc’ HoLEP with early apical release in men with benign prostatic hyperplasia», World J. Urol., vol. 37, n.o 11, pp. 2451-2458, nov. 2019, doi: 10.1007/s00345-019-02671-4.

[8] G. Geirsson, M. Fall, y S. Lindstrom, «The Ice?water Test—A Simple and Valuable Supplement to Routine Cytometry», Br. J. Urol., vol. 71, n.o 6, pp. 681-685, jun. 1993, doi: 10.1111/j.1464-410X.1993.tb16065.x.

[9] M. Emberton et al., «The National Prostatectomy Audit: the clinical management of patients during hospital admission», Br. J. Urol., vol. 75, n.o 3, pp. 301-316, mar. 1995, doi: 10.1111/j.1464-410X.1995.tb07341.x.

[10] J. L. Donovan et al., «A randomized trial comparing transurethral resection of the prostate, laser therapy and conservative treatment of men with symptoms associated with benign prostatic enlargement: The CLasP study», J. Urol., vol. 164, n.o 1, pp. 65-70, jul. 2000.

[11] B. Djavan, S. Madersbacher, C. Klingler, y M. Marberger, URODYNAMIC ASSESSMENT OF PATIENTS WITH ACUTE URINARY RETENTION: IS TREATMENT FAILURE AFTER PROSTATECTOMY PREDICTABLE?», J. Urol., vol. 158, n.o 5, pp. 1829-1833, nov. 1997, doi: 10.1016/S0022-5347(01)64139-9.

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