Perioperative Outcomes of Holmium Laser Enucleation of the Prostate: A Systematic Review

2021 ◽  
pp. 1-13
Author(s):  
Angelo Porreca ◽  
Michele Colicchia ◽  
Alessandro Tafuri ◽  
Daniele D’Agostino ◽  
Gian Maria Busetto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Surgical Complications ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
Holmium Laser ◽  
Perioperative Outcomes ◽  
Safe Procedure ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

<b><i>Introduction:</i></b> The aim of the study was to systematically review the literature and describe perioperative complications of holmium laser enucleation of the prostate (HoLEP), including the Clavien-Dindo classification of surgical complications. <b><i>Methods:</i></b> All English language publications on HoLEP were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines to evaluate PubMed<sup>®</sup>, Scopus<sup>®</sup>, and Web of Science™ databases from January 1, 1998, to June 1, 2020. <b><i>Results:</i></b> Fifty-seven studies were included, for a total of 10,371 procedures. We distinguished between intra-, peri-, and postoperative complications. Overall, the rate of complications is 0–7%. Intraoperative complications include incomplete morcellation (2.3%), capsular perforation (2.2%), bladder (2.4%), and ureteric orifice (0.4%) injuries. Perioperative complications include postoperative urinary retention (0.2%), hematuria and clot retention (2.6%), and cystoscopy for clot evacuation (0.7%). Postoperative complications include dysuria (7.5%), stress (4.0%), urge (1.8%), transient (7%) and permanent (1.3%) urinary incontinence, urethral stricture (2%) and bladder neck contracture (1%). <b><i>Conclusions:</i></b> HoLEP is a safe procedure, with a satisfactory low complication rate. The most common reported perioperative complications are not severe (Clavien-Dindo classification grades 1–2). Further randomized studies are certainly warranted to fully determine the predictor of surgical complications in order to prevent them and improve this technique.

scholarly journals MP62-19 HOLMIUM LASER ENUCLEATION OF THE PROSTATE: PERIOPERATIVE OUTCOMES FOR SAME DAY PROCEDURES

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Aye Lwin ◽  
Kieran Hynes ◽  
Michael Phung ◽  
Elinora Price ◽  
Christian Twiss ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Perioperative Outcomes ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Is Holmium Laser Enucleation of the Prostate a Good Surgical Alternative in Benign Prostatic Hyperplasia Management? A Review Article

2020 ◽  
Vol 11 (2) ◽  
pp. 197-203 ◽  
Author(s):  
Amirreza Abedi ◽  
Mohammad Reza Razzaghi ◽  
Amirhossein Rahavian ◽  
Ebrahim Hazrati ◽  
Fereshte Aliakbari ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Specific Antigen ◽  
Young Patients ◽  
Outlet Obstruction ◽  
Prostatic Hyperplasia ◽  
Holmium Laser ◽  
Safe Procedure ◽  
Open Prostatectomy ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Several therapeutic approaches such as holmium laser enucleation of the prostate (HoLEP) have been introduced to relieve bladder outlet obstruction caused by benign prostatic hyperplasia (BPH). Compared with other techniques including the transurethral resection of the prostate (TURP) and simple open prostatectomy, HoLEP results in a shorter hospital stay and catheterization time and fewer blood loss and transfusions. HoLEP is a size-independent treatment option for BPH with average gland size from 36 g to 170 g. HoLEP is a safe procedure in patients receiving an anticoagulant and has no significant influence on the hemoglobin level. Also, HoLEP is an easy and safe technique in patients with a prior history of prostate surgery and a need for retreatment because of adenoma regrowth. The postoperative erectile dysfunction rate of patients treated with HoLEP is similar to TURP or open prostatectomy and about 77% of these patients experience loss of ejaculation. Patients with transitional zone volume less than 30 mL may suffer from persistent stress urinary incontinence following HoLEP so other surgical techniques like bipolar TURP are a good choice for these patients. In young patients, considering HoLEP with high prostate-specific antigen density and a negative standard template prostate biopsy, multiparametric MRI needs to be considered to exclude prostate cancer.

Comparison of Perioperative Outcomes Between Holmium Laser Enucleation of the Prostate and Robot-Assisted Simple Prostatectomy

2017 ◽  
Vol 31 (9) ◽  
pp. 847-850 ◽  
Author(s):  
Mimi W. Zhang ◽  
Marawan M. El Tayeb ◽  
Michael S. Borofsky ◽  
Casey A. Dauw ◽  
Kristofer R. Wagner ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Simple Prostatectomy ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

The effect of prostatic tissue density on the perioperative outcomes of Holmium laser enucleation of prostate (HoLEP): a pilot study

2019 ◽  
Vol 38 (2) ◽  
pp. 455-461
Author(s):  
Engin Kaya ◽  
Eymen Gazel ◽  
Serdar Yalcın ◽  
Theodoros Tokas ◽  
Tahsin Batuhan Aydogan ◽  
...  
Keyword(s):  
Pilot Study ◽  
Prostatic Tissue ◽  
Holmium Laser ◽  
Perioperative Outcomes ◽  
Tissue Density ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Towards optimizing prostate tissue retrieval following holmium laser enucleation of the prostate (HoLEP): Assessment of two morcellators and review of literature

2015 ◽  
Vol 9 (9-10) ◽  
pp. 618 ◽  
Author(s):  
Ahmed M. Elshal ◽  
Ramy Mekkawy ◽  
Mahmoud Laymon ◽  
Ahmed El-Assmy ◽  
Ahmed R. El-Nahas
Keyword(s):  
Perioperative Complications ◽  
Mucosal Injury ◽  
Prostate Tissue ◽  
Holmium Laser ◽  
Medline Search ◽  
Retrieval Rate ◽  
Significant Difference ◽  
Laser Enucleation ◽  
Prostate Adenoma ◽  
Holmium Laser Enucleation

Introduction: We assess different approaches to retrieve the enucleated adenoma after transurethral enucleation of the prostate, particularly using the holmium laser.Methods: A retrospective review through our prospectively maintained database was performed looking for safety and efficacy of two morcellators. The enucleation phase of the holmium laser enucleation of the prostate (HoLEP) was classically performed followed by retrieval of the intravesical adenoma using either the Piranha (Wolf Inc., Knittlingen, Germany) or VersaCut (Lumenis) morcellator. A PubMed-MEDLINE search was conducted for all transurethral enucleation procedures and relevant data regarding methods of prostate tissue retrieval were extracted.Results: Strictly limiting the study to 3 reusable blades with each morcellator, we performed 67 and 55 consecutive procedures with Piranha and VersaCut, respectively. There was no significant difference between the two morcellators regarding perioperative complications, apart from 5 bladder mucosal injuries with the VersaCut (9%). Furthermore, there were similar retrieved tissue weight, mechanical problems-rate, catheter-time and hospital-stay in both morcellators. However, the Piranha morcellator needed significantly less morcellation-time, needed to use cold loop to remove non-morcellated pieces and to score the adenoma by laser for better bite of the adenoma, and had a higher median morcellation-rate 6.2 (rate: 2.8–12) g/min. Despite little reporting on morcellation, we had data on the tissue retrieval rate (2.6 to 6.5 g/min with Piranha and 1.9 to 11 g/min with VersaCut. Furthermore, bladder mucosal injury was reported in 1.4% and 0.7 to 5.7% with Piranha and VersaCut, respectively; bladder perforation with VersaCut was experienced in about 0.1 to 1.5% of patients. Our study is limited by its non-randomization.Conclusion: The Piranha morcellator was the most efficient and safe way to retrieve tissue after a transurethral enucleation of a prostate adenoma.

Sign in / Sign up

Export Citation Format

Share Document