Comparison of the efficacy of holmium laser enucleation in ≤80 mL and >80 mL prostate size

2018 ◽  
Vol 17 (4) ◽  
pp. e2101
Author(s):  
E. Gazel ◽  
E. Kaya ◽  
S. Yalcin ◽  
H.C. Aybal ◽  
T.B. Aydogan ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Prostate Size ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Influence of prostate size on the outcome of holmium laser enucleation of the prostate

2008 ◽  
Vol 101 (12) ◽  
pp. 1536-1541 ◽  
Author(s):  
Hemendra N. Shah ◽  
Hiren S. Sodha ◽  
Shabbir J. Kharodawala ◽  
Amit A. Khandkar ◽  
Sunil S. Hegde ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Prostate Size ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Holmium Laser Enucleation of the Prostate Efficiency by Prostate Gland Size: Is There a Sweet Spot?

Uro ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 202-208
Author(s):  
Mark Alexander Assmus ◽  
Tim Large ◽  
Amy Krambeck
Keyword(s):  
Prostate Gland ◽  
Holmium Laser ◽  
Prostate Hyperplasia ◽  
Gland Size ◽  
Tissue Weight ◽  
Wide Range ◽  
Prostate Size ◽  
Laser Enucleation ◽  
Post Hoc ◽  
Holmium Laser Enucleation

Holmium laser enucleation of the prostate (HoLEP) is one of only two AUA guideline-recommended prostate size-independent surgeries for benign prostate hyperplasia (BPH). The significant variation in gland size treated results in a wide range of enucleation and morcellation times. We sought to understand the effect of prostate size on HoLEP efficiency to better educate patients and improve operative room utilization. After IRB approval, we identified patients from 1 July 2016 to 1 January 2020 who underwent HoLEP by two endourologists. Our primary objectives were to assess the effects of increasing increments (25 g) of mean enucleated prostate tissue weight on enucleation and morcellation efficiency (g/min). One-way Kruskal–Wallis ANOVA with Dunn’s post hoc test was used, with significant p < 0.05. We included 675 HoLEPs with all comers mean tissue weight resected of 72.1 g (Range 1–448 g), energy used 110.00 kJ (10.73–340 kJ), enucleation time 48.6 min (5–151 min), and morcellation time 10.1 min (0.5–113 min). Average enucleation efficiency increased with increasing prostate size categories (e.g., <25 g–0.48 g/min, >325 g–3.91 g/min) (K-W ANOVA p = 0.004, Dunn’s post hoc p = 0.004). The combined average enucleation and morcellation efficiency was ≥5 g/min between 55 and 271 g. Inefficiency for cases <55 g was driven by enucleation, while >271 g case inefficiency was driven by morcellation. Increasing tissue weight at the time of HoLEP is associated with a linear relationship of increasing enucleation and decreasing morcellation efficiencies.

1735: Holmium Laser Enucleation of the Prostate: Outcomes are Independent of Prostate Size

2007 ◽  
Vol 177 (4S) ◽  
pp. 577-577 ◽  
Author(s):  
Mitchell R. Humphreys ◽  
Nicole L. Miller ◽  
Shelly E. Handa ◽  
Samuel C. Kim ◽  
Ramsay L. Kuo ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Prostate Size ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Holmium Laser Enucleation of the Prostate—Outcomes Independent of Prostate Size?

2008 ◽  
Vol 180 (6) ◽  
pp. 2431-2435 ◽  
Author(s):  
Mitchell R. Humphreys ◽  
Nicole L. Miller ◽  
Shelly E. Handa ◽  
Colin Terry ◽  
Larry C. Munch ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Prostate Size ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Ejaculation preserving HoLEP/TURP for benign prostatic hyperplasia: myth or reality

2021 ◽  
pp. 205141582110001
Author(s):  
Malik Abdul Rouf ◽  
Venkatesh Kumar ◽  
Anshuman Agarwal ◽  
Suresh Rawat
Keyword(s):  
Sexual Satisfaction ◽  
Transurethral Resection ◽  
International Prostate Symptom Score ◽  
Specific Antigen ◽  
Prostatic Hyperplasia ◽  
Holmium Laser ◽  
Peripheral Vascular ◽  
Prostate Size ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Objectives: To analyze whether technical modifications during transurethral resection of the prostate/holmium laser enucleation of the prostate results in preservation of antegrade ejaculation, at the same time providing effective relief from bladder outlet obstruction. Materials and methods: A total of 119 patients with benign prostatic hyperplasia were included in the study carried out at our center between March 2016 and December 2018. The patients were divided into two groups, with 56 (47.06%) patients in the ejaculation-preserving transurethral resection of the prostate group and 63 (52.94%) patients in the ejaculation-preserving holmium laser enucleation of the prostate group. The patients in the two groups were assessed with respect to age, prostate size, serum prostate-specific antigen and any comorbidity. The parameters assessed pre and postoperatively include Qmax, international prostate symptom score, peripheral vascular resistance, overall sexual satisfaction and overall ejaculation. All patients were regularly followed up during the study period and were included in the final analysis. Results: The mean (standard deviation) age, prostate size, serum prostate-specific antigen of patients who underwent ejaculation-preserving transurethral resection of the prostate and patients who underwent ejaculation-preserving holmium laser enucleation of the prostate was 61.67 (5.26)/61.48 (5.40) years, 59.75 (10.61) ml/74.44 (20.27) ml, 2.38 (0.77) ng/ml/2.47 (0.83) ng/ml, respectively. Postoperatively there was a statistically significant improvement in Qmax, international prostate symptom score and peripheral vascular resistance in both groups. The overall sexual satisfaction after surgery improved significantly in the ejaculation-preserving transurethral resection of the prostate group; however, it deteriorated significantly in the ejaculation-preserving holmium laser enucleation of the prostate group, which was statistically significant at 6 months. After treatment, the overall ejaculation assessed by asking question 9 of the international index of erectile function 15 questionnaire was unchanged in patients from the ejaculation-preserving transurethral resection of the prostate group and deteriorated in the ejaculation-preserving holmium laser enucleation of the prostate group and the difference between the two groups was statistically significant. Conclusion: An ejaculation preserving technique seems to be more feasible in small prostate glands when appreciable apical tissue is spared. However, holmium laser enucleation of the prostate is basically a size-independent procedure and enables the complete removal of the adenoma tissue like an open prostatectomy. To compromise the extent of tissue removal or candidate selection for a better ejaculation preservation outcome might damage the indigenous value of the holmium laser enucleation of the prostate. To conclude, if the preservation of sexual satisfaction and ejaculatory function is a priority, patients should be offered ejaculation-preserving transurethral resection of the prostate as the treatment of choice over ejaculation-preserving holmium laser enucleation of the prostate.

Holmium Laser Enucleation of Prostate in Patients With Prostate Size ≤60 cm3

Urology ◽  
2009 ◽  
Vol 73 (1) ◽  
pp. 95-99 ◽  
Author(s):  
Ehab A. Elzayat ◽  
Ismail Khalaf ◽  
Mohamed Elgallad ◽  
Hussein Hosny ◽  
Mostafa Elhilali
Keyword(s):  
Holmium Laser ◽  
Prostate Size ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation
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