Holmium laser enucleation of the prostate as a treatment option for patients with concurrent outlet obstruction and bladder diverticulum.

Background: A bladder diverticulum is a source of infections, urinary stones, and malignancy. Until recent years, patients suffering from large obstructive prostate and diverticulum were treated with open surgery, which also allowed diverticulectomy. The transition to a closed approach has led to diverticulum preservation. The clinical implications of this preservation strategy have not been sufficiently studied. Materials and methods: A retrospective comparison was made between holmium laser enucleation of the prostate (HoLEP) patients with a diverticulum (≥2 cm) and HoLEP patients without any diverticulum. For each patient with a diverticulum, two patients without a diverticulum who were operated on around the same time were matched (1:2). Patients operated on until March 2022 were included to allow for a relatively long follow-up period. Results: Out of 602 HoLEP patients, 32 (5%) had a diverticulum Conclusions: HoLEP is an effective treatment method for patients with bladder outlet obstruction and concomitant bladder diverticulum. By effectively relieving the bladder outlet obstruction, HoLEP can avoid the need for more invasive surgical interventions.