钬激光前列腺切除术（HoLEP）是一种治疗良性前列腺增生（BPH）和下尿路症状（LUTS）的大小无关的手术选择，具有出色、持久的功能结果。LUTS由于BPH和前列腺癌的患病率随年龄增加而增加，尽管这两种疾病是独立发展的。泌尿科医生常常面临诊断困境，因为患有LUTS的男性可能会出现PSA升高，因此需要诊断性检查以排除前列腺癌。然而，约15%的经过阴性PSA检查的男性将接受HoLEP和在HoLEP时诊断出偶发前列腺癌。实际上，前列腺癌经常在接受HoLEP的男性中发现，这种情况可能很难处理。与偶然发现的前列腺癌检测相关的变量、减少偶然发现的前列腺癌的策略，以及这种疾病的自然史和处理已经得到广泛的研究，但在这个领域还需要进一步工作。©2022 Springer Nature Limited.

Holmium laser enucleation of the prostate (HoLEP) is a size-independent surgical option for treating benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) with excellent, durable functional outcomes. The prevalence of LUTS secondary to BPH and prostate cancer both increase with age, although the two diseases develop independently. Urologists often face a diagnostic dilemma, as men with LUTS secondary to BPH might also present with an elevated PSA and, therefore, need a diagnostic work-up to exclude prostate cancer. Nevertheless, ~15% of men with a negative elevated PSA work-up will undergo HoLEP and will be diagnosed with incidental prostate cancer at the time of HoLEP. Indeed, prostate cancer is often found in men undergoing HoLEP, and this situation can be challenging to manage. Variables associated with the detection of incidental prostate cancer, strategies to reduce incidental prostate cancer, as well as the natural history and management of this condition have been extensively studied, but further work in this area is still needed.© 2022. Springer Nature Limited.