En-Bloc Technique With Anteroposterior Dissection Holmium Laser Enucleation of the Prostate Allows a Short Operative Time and Acceptable Outcomes

Urology ◽  
2015 ◽  
Vol 86 (3) ◽  
pp. 628-633 ◽  
Author(s):  
Shingo Minagawa ◽  
Shinsuke Okada ◽  
Hideo Sakamoto ◽  
Kosuke Toyofuku ◽  
Hirofumi Morikawa
Keyword(s):  
Operative Time ◽  
Holmium Laser ◽  
En Bloc ◽  
Short Operative Time ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giorgio Bozzini ◽  
Matteo Maltagliati ◽  
Umberto Besana ◽  
Lorenzo Berti ◽  
Albert Calori ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Randomized Study ◽  
Urine Volume ◽  
Holmium Laser ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation ◽  
Irrigation Volume

Abstract Background To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

scholarly journals Preoperative predictors of enucleation time during en bloc no-touch holmium laser enucleation of the prostate

2020 ◽  
Author(s):  
Chun-Hsuan Lin ◽  
Ching-Chia Li ◽  
Wen-Jeng Wu ◽  
Sheng-Chen Wen
Keyword(s):  
Operation Time ◽  
Holmium Laser ◽  
En Bloc ◽  
Symptomatic Benign Prostatic Hyperplasia ◽  
Clinical Variables ◽  
Specimen Weight ◽  
History Of ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation ◽  
Preoperative Predictors

Abstract Background To evaluate preoperative predictors of enucleation time during en bloc no-touch holmium laser enucleation of the prostate (HoLEP) Methods We enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc no-touch HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times. Result The average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of anticoagulation, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight. Conclusion En bloc no-touch HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and anticoagulation were correlated with increased operative time.

Holmium laser enucleation of prostate (HoLEP) procedure by an en-bloc and bladder neck preservation technique

ASVIDE ◽  
2021 ◽  
Vol 8 ◽  
pp. 023-023
Author(s):  
Pu Li ◽  
Chengming Wang ◽  
Min Tang ◽  
Peng Han ◽  
Xiaoxin Meng
Keyword(s):  
Bladder Neck ◽  
Holmium Laser ◽  
En Bloc ◽  
Laser Enucleation ◽  
Neck Preservation ◽  
Holmium Laser Enucleation ◽  
Preservation Technique

scholarly journals Preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chun-Hsuan Lin ◽  
Wen-Jeng Wu ◽  
Ching-Chia Li ◽  
Sheng-Chen Wen
Keyword(s):  
Operation Time ◽  
Antiplatelet Agents ◽  
Holmium Laser ◽  
En Bloc ◽  
Clinical Variables ◽  
Specimen Weight ◽  
History Of ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation ◽  
Preoperative Predictors

Abstract Background To evaluate preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate (HoLEP) Methods We enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc ‘no-touch’ HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times. Result The average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of antiplatelet agents, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight. Conclusion En bloc ‘no-touch’ HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and antiplatelet agents were correlated with increased operative time.

scholarly journals Comparison of different en bloc holmium laser enucleation of the prostate techniques to reduce the rate of postoperative transient urinary incontinence

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110374
Author(s):  
Chun-Hsuan Lin ◽  
Wen-Jeng Wu ◽  
Ching-Chia Li ◽  
Hung-Lung Ke ◽  
Jhen-Hao Jhan ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Intraoperative Complications ◽  
Urine Volume ◽  
Outlet Obstruction ◽  
Holmium Laser ◽  
Urinary Flow ◽  
En Bloc ◽  
Postvoid Residual Urine ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Objective To investigate postoperative risk factors for transient urinary incontinence (TUI) after different en bloc holmium laser enucleation of the prostate (HoLEP) techniques. Methods We retrospectively analyzed 169 consecutive patients who underwent HoLEP using the original en bloc technique (n = 41), en bloc with early mucosal strip detachment technique (n = 72), and three horseshoe-shaped incisions technique (n = 56) to treat bladder outlet obstruction from January 2017 to October 2019. Preoperative variables and surgical quality indexes were compared between the groups. TUI was defined as any hygienic or social problem caused by involuntary loss of urine at 2 weeks postoperatively. The postvoid residual urine volume, maximum urinary flow rate, and International Prostate Symptom Score (IPSS) were assessed. Results Among all three techniques, the three horseshoe-shaped incisions technique was significantly associated with the lowest incidence of TUI and the lowest IPSS. Although not statistically significant, the three horseshoe-shaped incisions group also showed a trend toward a faster enucleation time. No life-threatening intraoperative complications occurred in any group. Conclusion Use of three horseshoe-shaped incisions in en bloc HoLEP prevented urethral sphincter damage with a low rate of postoperative TUI. Further long-term, multicenter comparative assessment is required. Research Registry number: 6848

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