Clinical Characteristics Associated with the Formation of Non-morcellable Prostate Fragments in Patients Treated with Holmium Laser Prostatic Enucleation

Abstract

Aims: To describe the association of age, pre-operative prostate volume, total prostate-specific antigen, history of type 2 diabetes mellitus and systemic arterial hypertension with the risk of formation of non-morcellable fragments during prostate enucleation with holmium laser. Material and methods: Data were extracted from the database of the Urology Service of the Regional High Specialty Hospital of the Yucatan Peninsula. The variables that were analyzed are; age, medical history of systemic arterial hypertension and type 2 diabetes mellitus, pre-surgical prostate volume, pre-surgical total prostate-specific antigen and the formation of non-morcellable prostatic adenoma fragments called “Beach Ball”. Observational, retrospective, cross-sectional and descriptive study. Results: 43 patients were analyzed. The average age was 69 years. It was evident that 32% of the patients operated on with HoLEP formed Beach Ball. The variables associated with increasing the risk of forming said non-morcellable prostate adenoma fragments are; prostate volume ≥ 65 cc, prostate antigen ≥ 4 ng/ml and age ≥ 65 years. Conclusions: Our incidence of the formation of the so-called “Beach Ball” effect was 33%. Patients with prostate volume of ≥ 65 cc or more had a 5-fold increased risk of beach ball formation. Patients with total prostate antigen ≥ 4 ng/ml have this risk 2.53 times higher. And finally, patients aged ≥ 65 years have 1.52 times the risk.