Introduction: We sought to compare the outcomes of holmium laser enucleation of prostate (HoLEP) in benign prostatic hyperplasia (BPH) patients with voiding vs. storage symptoms.

Methods: From February 2015 to December 2020, we reviewed the charts of BPH patients who had HoLEP for voiding or storage lower urinary tract symptoms (LUTS). We excluded patients who had BPH with bladder stones, gross hematuria, or neurogenic bladder. Patients’ characteristics, preoperative symptomatology, preoperative urodynamics study (UDS) parameters, preoperative International Prostate Symptom Score (IPSS), postoperative symptomatology, IPSS, procedure complications, and postoperative need for further treatment were collected, analyzed, and compared.

Results: A total of 132 patients were included in the analysis. Patients were divided into two groups based on their predominant symptomatology: group 1 included patients with predominant voiding symptoms (68 patients), while group 2 involved those with predominant storage symptoms (64 patients). HoLEP was equally effective in symptom improvement of both groups, with no significant difference in the postoperative decrease in IPSS between both groups. This was true at both three-month (p=0.842) and six-month (p=0.483) followup even though the IPSS was significantly higher in group 1 than in group 2 preoperatively (p=0.010) (Table 1).

Conclusions: Irrespective of preoperative predominant symptoms, HoLEP has evident rates of postoperative symptom improvement and patient satisfaction, as evidenced by the proportionate improvement in IPSS.