scholarly journals Day-case holmium laser enucleation of the prostate: feasibility, safety and predictive factors

2018 ◽  
Vol 100 (6) ◽  
pp. 475-479 ◽  
Author(s):  
S-M Lee ◽  
K Gordon ◽  
R McMillan ◽  
F Crystal ◽  
P Acher
Keyword(s):  
Hospital Stay ◽  
Predictive Factors ◽  
Length Of Hospital Stay ◽  
Day Length ◽  
Holmium Laser ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. We assessed the feasibility and safety of day-case HoLEP and examined predictive factors for increased length of hospital stay. Materials and methods Patients presenting for HoLEP by a single surgeon from September 2013 to September 2016 were considered for day-case surgery. Patients were discharged following assessment by the operating surgeon and met predetermined discharge criteria. Factors contributing to day-case success were identified. Results In total, 210 patients (mean age 70.3 ± 8.5 years) underwent HoLEP, with 74 (35.3%) discharged as true day-cases and a further 84 (40.0%) discharged within 23 hours. Readmission rate was 5.5%, with all complications Clavien–Dindo grade I or II. Factors associated with successful day-case operation included low-volume prostates (≤ 40 g) (odds ratio, OR, 3.097, 95% confidence interval, CI, 1.619–5.924, P = 0.0001) and morning surgical lists (OR 6.124, 95% CI 2.526-14.845, p<0.001). Discussion and conclusion Day-case HoLEP is both feasible and safe, with low readmission rates. Two factors were significantly associated with successful day-case surgery: small volume prostate and morning theatre lists. Addressing these factors through preoperative planning can improve day-case surgery rates and improve bed throughput.

965 Holmium laser enucleation of the prostate (HoLEP) as a day case surgery

2016 ◽  
Vol 15 (3) ◽  
pp. e965-e965a
Author(s):  
V. Comat ◽  
G. Pierquet ◽  
J-C. Bernhard ◽  
G. Capon ◽  
G. Pasticier ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Initial experience with holmium laser enucleation of the prostate in a urology specialist hospital in Nigeria

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Celsus Ukelina Undie ◽  
Ewomazino Ibanga Nnana ◽  
Kalenebari Raymond Torporo
Keyword(s):  
Hospital Stay ◽  
Specific Antigen ◽  
Urine Volume ◽  
Length Of Hospital Stay ◽  
Maximum Flow ◽  
Holmium Laser ◽  
Initial Experience ◽  
Residual Urine Volume ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

Abstract Background Holmium laser enucleation of the prostate (HoLEP) is a more recent procedure for the management of Benign Prostatic Hyperplasia compared to open prostatectomy or Transurethral Resection of the Prostate. HoLEP is not commonly done in Nigeria. The objective of the study was to determine whether our initial experience with HoLEP in Abuja, favourably compared to those of other centres across the world. Methods A retrospective study was done on 40 patients who had HoLEP between October 2018 and December 2019. Pre- and post-operative International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), prostate sizes, maximum flow rate (Qmax) and post-void residual urine volume (PVR) were collated. The duration of irrigation, catheterization and length of hospital stay were also recorded and analysed. Complications were documented. Results There were improvements in IPSS from 19.67 to 5.41, PSA from 8.07 to 2.03 ng/ml,Qmax from 11.27 to 29.67 ml/min, PVR from 88.99 to 32.8 ml, while average prostate sizes reduced from 116.54 to 30.3 g after surgery. Following HoLEP, the duration of irrigation was 18.00 h, catheterization was 26.76 h and length of hospital stay was 1.82 days. Two (5.0%) patients were recatheterized, 4 (10.0%) developed post-operative bladder neck stenosis. Conclusions The outcome of HoLEP in our experience compared favourably with those from other centres. With adequate training and requisite equipment in resource-poor environments, technical procedures like HoLEP can be embarked on with favourable results.

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.

Day-case holmium laser enucleation of the prostate

2014 ◽  
Vol 8 (4) ◽  
pp. 268-273
Author(s):  
Mark Cynk ◽  
Georgios Georgiadis ◽  
Emily Moore ◽  
Jonathan Appleby ◽  
Richard Griffiths ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Day Case ◽  
Laser Enucleation ◽  
Holmium Laser Enucleation

scholarly journals Predictive factors of postoperative pain after day-case surgery

Acute Pain ◽  
2009 ◽  
Vol 11 (3-4) ◽  
pp. 147 ◽  
Author(s):  
H.F. Gramke ◽  
J.M. de Rijke ◽  
M. van Kleef ◽  
A.G. Kessels ◽  
M.L. Peters ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Predictive Factors ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery

Predictive factors for unanticipated admission following day case surgery

2008 ◽  
Vol 14 (1) ◽  
pp. 175-177 ◽  
Author(s):  
Giuseppe Garcea ◽  
Ibrar Majid ◽  
Clare J. Pattenden ◽  
Christopher D. Sutton ◽  
Christopher P. Neal ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Unanticipated Admission

scholarly journals Introducing holmium laser enucleation of the prostate alongside transurethral resection of the prostate improves outcomes of each procedure

2013 ◽  
Vol 95 (5) ◽  
pp. 365-368 ◽  
Author(s):  
N Wilson ◽  
M Mikhail ◽  
P Acher ◽  
R Lodge ◽  
A Young
Keyword(s):  
Blood Transfusion ◽  
Transurethral Resection ◽  
Length Of Hospital Stay ◽  
Holmium Laser ◽  
Control Group ◽  
Blood Transfusions ◽  
Group Data ◽  
Laser Enucleation ◽  
The Mean ◽  
Holmium Laser Enucleation

Introduction Holmium laser enucleation of the prostate (HoLEP) is recognised as an alternative to transurethral resection of the prostate (TURP). HoLEP has been demonstrated to be at least as effective as TURP with less morbidity but its introduction to practice has been limited in part by the learning curve of a novel procedure. This study examined the effects of introducing HoLEP alongside an established practice of TURP on early morbidity and length of hospital stay (LOS). Methods A retrospective review of all patients who underwent HoLEP and TURP between April 2007 and July 2011 was undertaken. HoLEP was introduced in April 2008; patients undergoing TURP before this were considered as a historical control group. Data were collected concerning resection/enucleation weight, blood transfusions and LOS. Results Overall, 772 patients underwent HoLEP or TURP within the 52-month study period: 164 underwent TURP prior to the introduction of HoLEP (TURP-A), 425 had TURP after the introduction of HoLEP (TURP-B) and 183 underwent HoLEP. The mean removed weight was 24g (standard deviation [SD]: 21g) for TURP-A, 19g for TURP-B (SD: 16g) and 38g (SD: 32g) for HoLEP (p<0.005). Blood transfusion rates were 5.5%, 2.2% and 1.6% for the TURP-A, TURP-B and HoLEP groups respectively (p<0.05). For TURP-A patients, the mean LOS was 5.6 days (SD: 3.5 days, 95% confidence interval [CI]: 5.3–6.0 days). The mean LOS for TURP-B patients was 4.4 days (SD: 4.4 days, 95% CI: 4.2–4.8 days). HoLEP patients had a mean LOS of 3.0 days (SD: 3.0 days, 95% CI: 2.6–3.4 days). Conclusions The introduction of HoLEP alongside TURP is associated with lower rates of blood transfusion and shorter LOS for all patients. This is likely to be due to the use of HoLEP rather than TURP in patients with larger prostates, who are more likely to have complications.

scholarly journals Predictive Factors of Postoperative Pain After Day-case Surgery

2009 ◽  
Vol 25 (6) ◽  
pp. 455-460 ◽  
Author(s):  
Hans-Fritz Gramke ◽  
Janneke M. de Rijke ◽  
Maarten van Kleef ◽  
Alfons G. H. Kessels ◽  
Madelon L. Peters ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Predictive Factors ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery
Sign in / Sign up

Export Citation Format

Share Document