Westhofen T, Schott M, Keller P, et al. - For high-risk patients undergoing Holmium laser enucleation of the prostate (HoLEP), spinal anesthesia (SpA) affords a safe and efficient alternative to general anesthesia (GA).

• Patients managed for lower urinary tract symptoms with HoLEP (n=300) in SpA with ASA>2 (n=100), GA with ASA>2 (GA-high-risk) (n=100) or GA with ASA≤2 (GA-low-risk) (n=100) were included.

• Propensity-score-matching was applied.

• SpA offered a comparable functional outcome to GA.

• SpA provided greater hemodynamic stability, faster overall postoperative recovery with preferable pain management.