Yunus KAYALI, Tahsin Batuhan AYDOGAN, Alpcan TORUN, Ali SOLEIMANPOUR, Ata GHASEMZADEH, Bilal ERYILDIRIM
Southern Clinics of Istanbul Eurasia - 2026;37(3):249-256
Objective: To evaluate patient-reported satisfaction and symptom improvement after holmium laser enucleation of the prostate (HoLEP) in a real-world cohort using a structured postoperative telephone survey. Methods: This single-center observational follow-up study combined retrospective chart review with a structured telephone questionnaire. All HoLEP procedures performed between January 2023 and January 2026 were screened (n=519). Among 462 contact-eligible patients, 209 provided verbal consent and completed the survey in March 2026. The questionnaire assessed global satisfaction, perceived change in voiding symptoms, willingness to undergo HoLEP again, willingness to recommend the procedure, temporal changes in satisfaction, residual symptoms, symptom-related bother, and need for additional treatment. Results: Favorable overall satisfaction was reported by 146 patients (69.9%), and 184 (88.0%) reported improvement in voiding complaints. In addition, 149 patients (71.3%) stated that they would choose the same operation again, and 143 (68.4%) would recommend HoLEP to others. Favorable satisfaction increased from 22.0% in the first postoperative week to 68.9% at interview. Urinary incontinence was the most frequent residual complaint (78.0%). Less favorable satisfaction was associated with residual symptoms and additional medication requirement (both p<0.0001). Longer follow-up showed a weak association with better satisfaction (rho=0.269, p<0.0001). Conclusions: HoLEP was associated with substantial patient-reported symptom improvement and generally favorable postoperative appraisal. However, satisfaction was dynamic and was closely related to residual symptoms, additional treatment, and postoperative recovery over time.
