攝護腺肥大所導致的下泌尿道症狀，是影響年長男性的重要疾病之一，在七十歲以上的男性有約八成的人都受到這樣的疾病所困擾著，是一個盛行率非常高的疾病。在過去，攝護腺肥大患者需要接受傳統剖腹剜除攝護腺阻塞的部分，手術失血多、復原慢且併發症多。一直到後來內視鏡的發展，以電刀在內視鏡下進行經尿道攝護腺刮除手術變成了攝護腺手術的黃金準則。而隨著時代的進步，醫療器材的提升也讓內視鏡的手術再次升級，『雷射內視鏡攝護腺剜除手術』在幾年的發展後，也逐漸取代傳統開刀以及內視鏡刮除而成為新的手術治療準則。

在這篇回顧性分析的文章中，作者們主要探討使用鈥雷射來作為攝護腺肥大的手術治療其目前的技術使用、預後、安全性、以及長期的效果是否穩定；也探討這項手術的副作用。

在這篇回顧的文獻中發現，目前對於這項手術的研究報導的數量已經非常多，顯示次手術已臻成熟，這些文章也證實了以雷射做攝護腺剜除手術是優於傳統的開腹或是電刀刮除手術。而在這些文獻中，不乏有手術後追蹤超過十年仍然保有術後療效的報導。在其中一篇隨機分派傳統電刀內視鏡刮除及雷射剜除的大型研究顯示，在七年之後，接受雷射剜除手術的這組比傳統電刀刮除的對照組，其多項預後數值都來得較為良好，像是：有更快的尿流速（4.36 mL/s）、有較好的性功能（IIEF 國際男性勃起功能指數評估高出2.39分）、移除的攝護腺也較多（移除的攝護腺檢體多出15.7克），至於其他像是術後下降的攝護腺特異抗原指數（PSA）以及排尿時膀胱內壓力較低等好處都有被發現。

總體而言，以（鈥）雷射作為內視鏡攝護腺剜除手術對於被攝護腺肥大造成下泌尿道症狀困擾的患者，可以有很好的且可信的治療效果。在歐洲以及美國泌尿科醫學會都已經將此術式列為症狀有中到重度的患者的建議手術治療選項之中。尤其是對於攝護腺過大、年紀較大、有出血風險等較為危險的患者，此術式是個很好的選擇。

Introduction: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one of the most common diseases affecting the aging man, with almost 80% of men greater than 70 affected. Historically, transurethral resection of the prostate (TURP) has been considered the historical gold standard in the treatment of LUTS due to BPH for many years, contemporary literature indicates that holmium laser enucleation of the prostate (HoLEP) has replaced TURP and open simple prostatectomy as the size independent surgical gold standard for BPH treatment.

Materials and methods: In this review, we discuss the current techniques utilized, outcomes and safety, as well as the long term durability of results. Adverse events associated with the HoLEP procedure, both enucleation and morcellation, are covered as well.

Results: HoLEP has a robust body of literature supporting the technique, which demonstrates its ability to surpass other surgical BPH procedures, including TURP and open simple prostatectomy. Additionally, there is long term durability of both subjective and objective outcomes greater than 10 years associated with this procedure. One randomized trial showed specific postoperative outcome measures that were superior to TURP at 7 years of follow up, including Qmax (4.36 mL/s improvement), erectile function (2.39 points improvement on the IIEF erectile function section), and weight of prostate removed (15.7 grams greater), while other studies have shown greater reduction in postoperative PSA, lower detrusor pressure at Qmax, and more.

Conclusions: Overall, HoLEP has proven to be an extremely durable and effective treatment for patients suffering from LUTS due to BPH. Both the Europeans and AUA guidelines on the surgical treatment of BPH recommend HoLEP as a size-independent treatment option for those men with moderate to severe symptoms. HoLEP is an excellent option for many patients who may not be good candidates for other procedures based on prostate size, age, or bleeding risk.