nach oben

World Journal of Urology

Erschienen in:

23.07.2018 | Original Article

“Three horse shoe-like incision” holmium laser enucleation of the prostate: first experience with a novel en bloc technique for anatomic transurethral prostatectomy

verfasst von: Arkadiusz Miernik, Dominik S. Schoeb

Erschienen in: World Journal of Urology | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

Objective

To demonstrate the performance of a novel holmium laser enucleation technique in patients with lower urinary tract symptoms (LUTS).

Materials and methods

Between September 2015 and August 2017, 114 consecutive patients underwent modified HoLEP [3 horse shoe-like incision HoLEP (3 HSI HoLEP)] for LUTS performed by an experienced urologist (A.M.). The surgical intervention and short postoperative course were analyzed. International Prostate Symptom Score (IPSS), quality of life score, maximum urinary flow rate (Q max), postvoid residual urine (PVR), and clinical and sociodemographic data were assessed preoperatively. The patient cohort was compared with existing data regarding clinical outcome parameters after surgical LUTS therapy.

Results

The mean size of the prostatic gland was 86.3 ± 46.5 mL. The mean total operative time was 49.6 min (15–280 min). IPSS, Q max, and PVR were 20.7, 10.8, and 112.7 mL, respectively, prior to the intervention in the 3 HSI HoLEP group. The complication rate for Clavien category-III complications was 4.4%; no category IV complications were recorded. Seven of 114 patients experienced urinary retention after catheter removal during the hospital stay.

Conclusions

The presented procedure provides several improvements over the standard modality. The prostatic gland is enucleated en bloc in an anatomical manner without longitudinal incisions of the urethra. This method is fast, safe, and may be easier to learn. However, this is the first description recorded. Future multicenter, controlled studies should clarify the long-term outcomes and surgical performance of 3 HSI HoLEP.

Nur mit Berechtigung zugänglich

Speakman M, Kirby R, Doyle S, Ioannou C (2015) Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH)—focus on the UK. BJU Int 115(4):508–519. https://doi.org/10.1111/bju.12745 CrossRefPubMed

Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, Lack N, Stief CG, Urology Section of the Bavarian Working Group for Quality A (2008) Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180(1):246–249. https://doi.org/10.1016/j.juro.2008.03.058 CrossRefPubMed

Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N, Stief CG, Reich O (2007) Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol 177(4):1419–1422. https://doi.org/10.1016/j.juro.2006.11.062 CrossRefPubMed

Gilling PJ, Cass CB, Cresswell MD, Fraundorfer MR (1996) Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology 47(1):48–51CrossRefPubMed

Jones P, Alzweri L, Rai BP, Somani BK, Bates C, Aboumarzouk OM (2016) Holmium laser enucleation versus simple prostatectomy for treating large prostates: results of a systematic review and meta-analysis. Arab J Urol 14(1):50–58. https://doi.org/10.1016/j.aju.2015.10.001 CrossRefPubMed

Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, Speakman MJ, Stief CG (2010) Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol 58(3):384–397. https://doi.org/10.1016/j.eururo.2010.06.005 CrossRefPubMed

Cornu JN, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, McVary K, Novara G, Woo H, Madersbacher S (2015) A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol 67(6):1066–1096. https://doi.org/10.1016/j.eururo.2014.06.017 CrossRefPubMed

Humphreys MR, Miller NL, Handa SE, Terry C, Munch LC, Lingeman JE (2008) Holmium laser enucleation of the prostate—outcomes independent of prostate size? J Urol 180(6):2431–2435. https://doi.org/10.1016/j.juro.2008.08.019 (discussion 2435) CrossRefPubMed

Gilling PJ, Fraundorfer MR (1998) Holmium laser prostatectomy: a technique in evolution. Curr Opin Urol 8(1):11–15CrossRefPubMed

10.

Scoffone CM, Cracco CM (2016) The en-bloc no-touch holmium laser enucleation of the prostate (HoLEP) technique. World J Urol 34(8):1175–1181. https://doi.org/10.1007/s00345-015-1741-y CrossRefPubMed

11.

Endo F, Shiga Y, Minagawa S, Iwabuchi T, Fujisaki A, Yashi M, Hattori K, Muraishi O (2010) Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology 76(6):1451–1455. https://doi.org/10.1016/j.urology.2010.03.071 CrossRefPubMed

12.

Kuo RL, Paterson RF, Kim SC, Siqueira TM Jr, Elhilali MM, Lingeman JE (2003) Holmium laser enucleation of the prostate (HoLEP): a technical update. World J Surg Oncol 1(1):6. https://doi.org/10.1186/1477-7819-1-6 CrossRefPubMedPubMedCentral

13.

Baazeem AS, Elmansy HM, Elhilali MM (2010) Holmium laser enucleation of the prostate: modified technical aspects. BJU Int 105(5):584–585. https://doi.org/10.1111/j.1464-410X.2009.09111.x CrossRefPubMed

14.

Gong YG, He DL, Wang MZ, Li XD, Zhu GD, Zheng ZH, Du YF, Chang LS, Nan XY (2012) Holmium laser enucleation of the prostate: a modified enucleation technique and initial results. J Urol 187(4):1336–1340. https://doi.org/10.1016/j.juro.2011.11.093 CrossRefPubMed

15.

Kim M, Lee HE, Oh SJ (2013) Technical aspects of holmium laser enucleation of the prostate for benign prostatic hyperplasia. Korean J Urol 54(9):570–579. https://doi.org/10.4111/kju.2013.54.9.570 CrossRefPubMedPubMedCentral

16.

Brunckhorst O, Ahmed K, Nehikhare O, Marra G, Challacombe B, Popert R (2015) Evaluation of the learning curve for holmium laser enucleation of the prostate using multiple outcome measures. Urology 86(4):824–829. https://doi.org/10.1016/j.urology.2015.07.021 CrossRefPubMed

17.

Elzayat EA, Habib EI, Elhilali MM (2005) Holmium laser enucleation of the prostate: a size-independent new “gold standard”. Urology 66(5 Suppl):108–113. https://doi.org/10.1016/j.urology.2005.06.006 CrossRefPubMed

18.

Kuo RL, Paterson RF, Kim SC, Siqueira TM Jr, Elhilali MM, Lingeman JE (2003) Holmium laser enucleation of the prostate (HoLEP): a technical update. World J Surg Oncol 1(1):6CrossRefPubMedPubMedCentral

19.

Minagawa S, Okada S, Sakamoto H, Toyofuku K, Morikawa H (2015) En-Bloc technique with anteroposterior dissection holmium laser enucleation of the prostate allows a short operative time and acceptable outcomes. Urology 86(3):628–633. https://doi.org/10.1016/j.urology.2015.06.009 CrossRefPubMed

20.

Saredi G, Pacchetti A, Pirola GM, Berti L, Ambrosini F, Martorana E, Marconi AM (2017) En-bloc thulium laser enucleation of the prostate: surgical technique and advantages compared with the classical technique. Urology. https://doi.org/10.1016/j.urology.2017.07.011 CrossRefPubMed

21.

Saredi G, Pacchetti A, Pirola GM, Berti L, Ambrosini F, Martorana E, Marconi AM (2017) En bloc thulium laser enucleation of the prostate: surgical technique and advantages compared with the classical technique. Urology 108:207–211. https://doi.org/10.1016/j.urology.2017.07.011 CrossRefPubMed

22.

Kuntz RM, Lehrich K, Ahyai SA (2008) Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 53(1):160–166. https://doi.org/10.1016/j.eururo.2007.08.036 CrossRefPubMed

23.

Ahyai SA, Chun FK, Lehrich K, Dahlem R, Zacharias MS, Fisch MM, Kuntz RM (2012) Transurethral holmium laser enucleation versus transurethral resection of the prostate and simple open prostatectomy–which procedure is faster? J Urol 187(5):1608–1613. https://doi.org/10.1016/j.juro.2011.12.107 CrossRefPubMed

24.

Cynk M (2014) Holmium laser enucleation of the prostate: a review of the clinical trial evidence. Ther Adv Urol 6(2):62–73. https://doi.org/10.1177/1756287213511509 CrossRefPubMedPubMedCentral

25.

Krambeck AE, Handa SE, Lingeman JE (2010) Holmium laser enucleation of the prostate for prostates larger than 175 grams. J Endourol 24(3):433–437. https://doi.org/10.1089/end.2009.0147 CrossRefPubMed

Titel: “Three horse shoe-like incision” holmium laser enucleation of the prostate: first experience with a novel en bloc technique for anatomic transurethral prostatectomy
verfasst von: Arkadiusz Miernik
Dominik S. Schoeb
Publikationsdatum: 23.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 3/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2418-0

Neu im Fachgebiet Urologie

24.04.2024 | DGIM 2024 | Nachrichten

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

“Three horse shoe-like incision” holmium laser enucleation of the prostate: first experience with a novel en bloc technique for anatomic transurethral prostatectomy

Abstract

Objective

Materials and methods

Results

Conclusions

Neu im Fachgebiet Urologie

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Stufenschema weist Prostatakarzinom zuverlässig nach

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Varikozelen bei Jugendlichen: Das Für und Wider der Operation

Update Urologie

Springer Medizin

Abstract

Objective

Materials and methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2019

Inverse stage migration patterns in North American patients undergoing local prostate cancer treatment: a contemporary population-based update in light of the 2012 USPSTF recommendations

Update on the ICUD-SIU consultation on multi-parametric magnetic resonance imaging in localised prostate cancer

Open partial nephrectomy when a non-flank approach is required: indications and outcomes

Effect of urodynamic preoperative detrusor overactivity on the outcomes of transurethral surgery in patients with male bladder outlet obstruction: a systematic review and meta-analysis

Beyond transrectal ultrasound-guided prostate biopsies: available techniques and approaches

Unintended consequences of decreased PSA-based prostate cancer screening

Neu im Fachgebiet Urologie

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Stufenschema weist Prostatakarzinom zuverlässig nach

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Varikozelen bei Jugendlichen: Das Für und Wider der Operation

Update Urologie