Introduction: The safety and durability of holmium laser enucleation of the prostate (HoLEP) are well-proven. However, the patient’s experience in a day-case setting has been undervalued. Our objective was to measure patients' perceived fear and anxiety during ambulatory HoLEP.

Methods: We performed a prospective, descriptive study on all patients presenting for day-case HoLEP in our institution from June 2020 to December 2021. In addition to oral information, a document describing the disease, the surgery, and the after-effects was given to the patient during the preoperative consultation. The week preceding the surgery, Surgical Fear Questionnaire (SFQ) and Hospital Anxiety and Depression Scale (HADS) were administered by phone per-ambulatory. The day following the surgery, the HADS questionnaire was repeated to evaluate the patient’s experience. Patients were questioned if they would undergo HoLEP in a day-case setting again. Day-case surgery success was defined as no hospital admission within 48 hours of the procedure.

Results: A total of 46 patients were eligible for day-case HoLEP (mean age 70.8±6.3). The ambulatory success rate was 85% (39/46). The mean SFQ score was 21.8/90 (range 0–41), with the two most reported items being “fear of pain” and “fear of side effects,” with respective means of 4.5/10 and 3.9/10. For HADS, pre-intervention score was 4.3/21 (range 0–16) and per-ambulatory score was 3.9/21 (range 0–12), with a mean change of -0.4. Only four patients (8.7%) had clinically significant HADS anxiety scores (10/21) in preoperative and three (7.6%) in per-ambulatory. In addition, 37/39 (95%) would undergo HoLEP in a day-case setting again, and 2/39 would, but under different conditions.

Conclusions: Overall, patients reported low levels of fear and anxiety in both the pre-intervention and per-ambulatory HoLEP setting, suggesting they were well-informed, in addition to receiving minimally invasive care in a suitable environment.