Evidence map›Paper›PMID 40886208›Full record

ArticleInternational urology and nephrology2026

Hidden findings: How often does Holmium laser enucleation of the prostate (HoLEP) uncover prostate cancer?

Suraj Pursnani, Sri Saran Manivasagam, Ernesto Mohr, Abdul-Jawad Majeed, Mandy Hsu, Elizabeth Zook, Noor Banihashem Ahmad, Joaquín Gurovich, Rodrigo Cañas, Erik B Lehman and 2 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Suraj PursnaniDepartment of Urology, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033, USA.
Sri Saran ManivasagamDepartment of Urology, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033, USA.
Ernesto MohrDepartment of Urology, Clinical Hospital of the University of Chile, Independencia, USA.
Abdul-Jawad MajeedDepartment of Urology, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033, USA.
Mandy HsuDepartment of Urology, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033, USA.
Elizabeth ZookDepartment of Urology, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033, USA.
Noor Banihashem AhmadDepartment of Urology, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033, USA.
Joaquín GurovichDepartment of Urology, Clinical Hospital of the University of Chile, Independencia, USA.
Rodrigo CañasDepartment of Urology, Clinical Hospital of the University of Chile, Independencia, USA.
Erik B LehmanDepartment of Public Health Sciences, Penn State College of Medicine, 500 University Dr, Hershey, PA, 17033, USA.
Rodrigo LedezmaDepartment of Urology, Clinical Hospital of the University of Chile, Independencia, USA.
Jay D RamanDepartment of Urology, Penn State College of Medicine, 500 University Dr., Hershey, PA, 17033, USA. jraman@pennstatehealth.psu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBenign prostatic hyperplasia (BPH) is a common condition with an increasing prevalence that parallels aging. Surgical procedures involving removal of the prostate can lead to detection of incidental prostate cancer (iPCa). Following holmium laser enucleation of the prostate (HoLEP), the incidence of such cases ranges from 5.6 to 23.3%. This study aims to provide a contemporary incidence of iPCa at HoLEP and associated risk factors.

methodsA multi-national retrospective cohort analysis of 579 patients who underwent HoLEP between 2021 and 2024 was performed. Prior to HoLEP, MRI was performed in 115 (20%) patients, of which 19 were diagnosed with PCa via conventional biopsy and were excluded from analysis. Clinical, demographic, and radiologic parameters were queried to determine association with iPCa and rates of clinically significant prostate cancer (csPCa).

resultsOf 560 HoLEP patients, 39 (7.0%) were found to have de novo PCa, of which 13 (2.3%) had csPCa at the time of surgery. Patients with iPCa were more likely to be of white race (59% vs 29%, p < 0.001), ASA Grade 3/4 (41% vs 22%, p < 0.001), and higher preoperative mean PSA (5.7 vs 4 ng/dl, p = 0.007). On multivariate analysis, only white race (OR: 1.29, p = 0.04) and HoLEP morcellation time (OR: 0.91, p = 0.03) were associated with iPCa diagnosis.

conclusionsIn an international HoLEP cohort, de novo PCa was detected in 7.0% of patients, with only 2.3% harboring clinically significant (≥ GG2) disease. Higher proportions of white men, men with ASA 3/4, and higher preoperative mean PSA were observed in iPCa. These data are valuable for appropriate preoperative patient counseling.

Indexed as

Incidental FindingsLasers, Solid-StateLaser TherapyProstatectomyProstatic HyperplasiaProstatic NeoplasmsAgedCohort StudiesHumansMaleMiddle AgedRetrospective StudiesBenign prostatic hyperplasiaClinically significant prostate cancerHoLEPIncidental prostate cancerRacial factors

Identifiers

PMID40886208
PMCPMC12935736

What Socratic holds

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