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Organo Oficial de la Sociedad Mexicana de Urología

2026, Number 1

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Rev Mex Urol 2026; 86 (1)

Incidence and risk factors associated with incidental prostate cancer in patients undergoing holmium laser enucleation of the prostate (HoLEP)

Medina LB, Pineda MJ, Montes MMÁ

Language: English
References: 22
Page: 1-12
PDF size: 596.18 Kb.


ABSTRACT

Objective: to evaluate the incidence and risk factors associated with the diagnosis of incidental prostate cancer (IPC) in patients undergoing holmium laser enucleation of the prostate (HoLEP).
Materials and Methods: A retrospective study was conducted in 145 patients who underwent HoLEP between 2022 and 2024. Clinical and biochemical variables were analyzed. Chi-square tests, Pearson’s correlation, and ROC curve analyses were applied. Statistical significance was set at p < 0.05.
Results: incidental prostate cancer was identified in 9 patients (6.2 %). Total prostate-specific antigen (t-PSA) and total PSA density (t-PSA-D) were significantly higher in the IPC group. t-PSA-D demonstrated the best predictive performance (AUC = 0.913; 95 % CI: 0.835–0.991; p < 0.001), followed by t-PSA (AUC = 0.844; p < 0.001) and age (AUC = 0.703; p = 0.014). A strong negative correlation was observed between enucleated volume and postoperative t-PSA levels (r = –0.77).
Study limitations: the retrospective and single-center design, as well as the sample size, may limit the generalizability of the results. Originality or value: the findings of this study may help optimize the preoperative selection of patients undergoing HoLEP.
Conclusions: the incidence of incidental prostate cancer was 6.2 %. t-PSA, t-PSA-D, and age were significantly associated with IPC diagnosis.


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