Prostatic Diseases and Male Voiding DysfunctionAnteroposterior Dissection HoLEP: A Modification to Prevent Transient Stress Urinary Incontinence
Section snippets
Subjects
The subjects were 68 BPH patients who had received HoLEP from January to December 2008 at St. Luke's International Hospital, Department of Urology. The first 31 patients from January to July had the HoLEP performed based on the Gilling's method12 (designated Surgery 1). For 37 patients from July to December, the revised method (anteroposterior dissection HoLEP) was used (designated Surgery 2). All surgeries were carried out by one operator who had conducted 80 HoLEP surgeries on patients by the
Results
In 2008, 68 HoLEP were performed at our institution. From January to July 31, HoLEP were performed based on Gilling's method (Surgery 1).12 After the revised method designated anteroposterior dissection HoLEP was introduced in July, 2037 surgeries were performed by this new method (Surgery 2).
Table 1 shows the characteristics of the subjects. For both groups of Surgery 1 and 2, the mean ages of the subjects were 70.1 ± 6.7 and 69.8 ± 7.1 years old, respectively. The estimated prostate volumes
Comment
Although HoLEP is expected to be a new gold standard surgery for BPH, frequent transient SUI is found after surgery.3, 4, 5, 6 The learning curve for overcoming SUI is relatively long. The previous studies have reported that it takes the experience of 20-30 cases3, 4 to reduce the SUI levels even in facilities with supervisory physicians, and about 50 cases without mentorship.5 Furthermore, even experienced surgeons have encountered transient SUI.3, 4 In our hospital, 25% of patients who
Conclusions
In this study, we have reported that our revised HoLEP, designated the anteroposterior dissection HoLEP, can decrease transient SUI rate. This method is simple and could shorten the learning curve for surgeons.
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