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

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.

Download Full-text

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

10.21203/rs.3.rs-36182/v2 ◽

2020 ◽

Author(s):

Chun-Hsuan Lin ◽

Ching-Chia Li ◽

Wen-Jeng Wu ◽

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.

Download Full-text

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

10.21203/rs.3.rs-36182/v3 ◽

2020 ◽

Author(s):

Chun-Hsuan Lin ◽

Ching-Chia Li ◽

Wen-Jeng Wu ◽

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.

Download Full-text

Robot-Assisted Radical Prostatectomy in Patients with a History of Holmium Laser Enucleation of the Prostate: Feasibility and Evaluation of Initial Outcomes

Journal of Endourology ◽

10.1089/end.2014.0767 ◽

2015 ◽

Vol 29 (7) ◽

pp. 764-769 ◽

Cited By ~ 10

Author(s):

Paul T. Gellhaus ◽

M. Francesca Monn ◽

Joshua Leese ◽

Chandra K. Flack ◽

James E. Lingeman ◽

...

Keyword(s):

Radical Prostatectomy ◽

Holmium Laser ◽

Robot Assisted ◽

History Of ◽

Laser Enucleation ◽

Holmium Laser Enucleation

Download Full-text

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

ASVIDE ◽

10.21037/asvide.2021.023 ◽

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

Download Full-text

DrillCutTM vs. VersaCutTM prostate tissue morcellation devices after holmium laser enucleation: A prospective, randomized controlled trial

Canadian Urological Association Journal ◽

10.5489/cuaj.5626 ◽

2018 ◽

Vol 13 (8) ◽

Cited By ~ 2

Author(s):

Ahmed Ibrahim ◽

Mostafa M. Elhilali ◽

Mohammed A. Elkoushy ◽

Sero Andonian ◽

Serge Carrier

Keyword(s):

Small Sample Size ◽

Controlled Trial ◽

Small Sample ◽

Holmium Laser ◽

Complication Rates ◽

Symptomatic Benign Prostatic Hyperplasia ◽

Significant Difference ◽

Ethical Approval ◽

Laser Enucleation ◽

Holmium Laser Enucleation

Introduction: We aimed to compare efficacy, safety, and cost of disposables of the DrillCutTM morcellator with the VersaCutTM morcellator after holmium laser enucleation of the prostate (HoLEP).Methods: After obtaining ethical approval, consecutive patients undergoing HoLEP for symptomatic benign prostatic hyperplasia were randomized to have their enucleated prostates morcellated by either Karl Storz® DrillCutTM or Lumenis® VersaCutTM morcellators. All procedures were performed by two experienced urologists. Patients’ demographics and perioperative data were recorded. Both morcellators were compared for their safety, efficacy, and cost-effectiveness.Results: Eighty-two patients were included in the study (41 per each arm). Both groups were comparable in terms of age, preoperative prostate size (114 vs. 112 mL; p>0.05), enucleation time (95.3 vs. 91.7 minutes; p>0.05), and morcellation time (22.6 vs. 17.3 minutes; p>0.05). The DrillCutTM was associated with significantly lower morcellation rate when compared with the VersaCutTM(3.6 vs. 4.9 g/min; p= 0.03). In terms of safety, there was no significant difference between both morcellators in complication rates (2.4% vs. 7.3 %; p=0.1). However, there was one case of bladder perforation requiring exploration with the VersaCutTM. The DrillCutTM was associated with significantly higher cost of disposables when compared with the VersaCutTM ($247.5 vs. $160.9; p<0.01).Conclusions: Despite the small sample size, the DrillCutTM was associated with lower morcellation rate when compared with the VersaCutTM. However, this difference may not be clinically significant. Although both morcellators were comparable in their safety, the DrillCutTM was associated with higher cost of disposables when compared with the VersaCutTM.

Download Full-text

Salvage Holmium laser enucleation of prostate to treat recurring benign prostatic hyperplasia

Canadian Urological Association Journal ◽

10.5489/cuaj.1494 ◽

2014 ◽

Vol 8 (3-4) ◽

pp. 235 ◽

Cited By ~ 3

Author(s):

Jin Kyu Oh ◽

Jungbum Bae ◽

Chang Wook Jeong ◽

Jae-Seung Paick ◽

Seung-June Oh

Keyword(s):

Operation Time ◽

Holmium Laser ◽

Time Duration ◽

Prostate Hyperplasia ◽

Laser Enucleation ◽

Group 2 ◽

Benign Prostate ◽

Holmium Laser Enucleation ◽

Anatomical Plane ◽

Group 1

Introduction: The Holmium laser enucleation of the prostate (HoLEP) technique to remove residual adenoma has not been reported. Salvage HoLEP enables anatomical enucleation of residual adenoma in patients who have previously undergone surgical treatment. We describe not only anatomical insights into the frequent location of adenoma recurrence, but also the feasibility of the salvage HoLEP technique.Methods: We retrospectively reviewed a database containing HoLEP video records for 35 patients out of a total of 535 individuals on whom HoLEP was performed by 2 surgeons (SJO & JSP) between July 2008 and June 2011. Group 1 consisted of patients who underwent salvage HoLEP due to recurring adenoma and Group 2 of patients who underwent HoLEP as an initially surgical management to treat benign prostate hyperplasia (BPH). We compared the dataset of pre-, intra- and postoperative parameters between Groups 1 and 2.Results: In the analysis of the video records of Group 1 (n = 35), there was significant remnant tissue around the verumontanum and the lateral lobes were also incompletely removed by previous conventional procedures. When we compared pre-, intra- and postoperative parameters between the 2 groups, there were no significant differences, including operation time, duration of hospital stay. However, the duration of the catheterization of Group 1 was shorter than that of Group 2 (1.38 ± 0.55 vs. 1.90 ± 1.81 days, p < 0.001).Conclusions: Even for cases of residual BPH, salvage HoLEP is a feasible and effective procedure for treating residual adenoma along the anatomical plane.

Download Full-text