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Research Article: Feasibility and safety of an F16 small-caliber catheter-based, irrigation-free protocol in BPH patients undergoing green laser enucleation of the prostate: a single-center retrospective cohort study

Date Published: 2026-10-01

Abstract:
GreenLight laser enucleation of the prostate (GreenLEP) offers superior hemostasis, raising the possibility of omitting postoperative continuous bladder irrigation. This study aimed to evaluate the feasibility and safety of an F16 small-diameter catheter non-irrigation protocol in BPH patients. A retrospective single-center study included 300 consecutive BPH patients undergoing GreenLEP at Yangjiang Hospital of Traditional Chinese Medicine between January 2024 and June 2025. The exposure was implementation of the F16 non-irrigation protocol. The primary outcome was successful completion without continuous bladder irrigation or secondary hemostatic intervention. Covariates included age, prostate volume (PV), operative time, ASA score, anticoagulant/antiplatelet use, urinary retention, preoperative catheterization, and concomitant bladder stones. Stratified analysis and ROC curve analysis were performed to explore predictors of failure. Overall, 265 patients (88.3%) successfully completed the non-irrigation protocol. Median hemoglobin decrease was 2.0?g/L (IQR 1–3), with no blood transfusions. In the parsimonious multivariable logistic regression model adjusted for age, prostate volume, ASA classification, and anticoagulant/antiplatelet use, prostate volume was not independently associated with MajorFailure (adjusted OR 1.14 per 10-mL increase, 95% CI 0.76–1.71, P =?0.527). ROC analysis suggested a PV cutoff of 76.35?mL for predicting failure (AUC 0.65, 95% CI 0.55–0.75). The F16 non-irrigation protocol after GreenLEP is safe and feasible, with high success rates and minimal perioperative bleeding. Increased PV and anticoagulant therapy modestly reduce success but do not preclude application. These findings support broader implementation of non-irrigation strategies to enhance postoperative comfort and recovery.

Introduction:
Benign prostatic hyperplasia (BPH) is among the most prevalent urological conditions affecting middle-aged and elderly men, with incidence rising sharply with advancing age ( 1 ). Data from the Global Burden of Disease (GBD) study indicate that the number of prevalent BPH cases among men aged ?60 years reached approximately 79 million in 2019—a more than 120% increase compared with 1990—and this upward trajectory is projected to continue through 2035 ( 2 ). Meta-analytical estimates place the global prevalence of…

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