Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience

Das, Akhil; Teplitsky, Seth; Chandrasekar, Thenappan; Perez, Tomy; Guo, Jenny; Leong, Joon Yau; Shenot, Patrick J.

doi:10.1590/s1677-5538.ibju.2019.0411

Cited by 26 publications

(20 citation statements)

References 27 publications

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“…Furthermore, the rate of postoperative incontinence was signi cantly higher in HoLEP than in B-TUVP. Urinary incontinence was well-documented as a major complication of HoLEP, with incidence rates at 10.7-16.2% [21][22][23][24] . Most case of urinary incontinence were reported as transient and, in this study, all urinary incontinence was transient and ceased without any treatment within 6 months.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the short-term efficacy and safety of bipolar transurethral electro vaporization and holmium laser enucleation of the prostate for moderate and large benign prostatic enlargement

Hayashi

Yoneyama²,

Takizawa³

et al. 2023

Preprint

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Background: To compare the efficacy and safety of bipolar transurethral vaporization of the prostate (B-TUVP) with holmium laser enucleation of the prostate (HoLEP) for moderate [prostate volume (PV) 30-80 ml] and large (≥ 80 ml) benign prostatic enlargement (BPE). Materials and Methods: Male patients with lower urinary tract symptom (LUTS) or urinary retention who underwent B-TUVP or HoLEP treatment in two regional, high-volume centers were respectively enrolled. The patient-oriented and treatment outcomes were retrospectively compared between B-TUVP and HoLEP. Results: B-TUVP showed shorter operative time and less hemoglobin decrease than in HoLEP. In uncatheterized patients, voiding symptoms and patients’ quality of life improved after B-TUVP and HoLEP, but these improvement rates were consistently bigger in HoLEP than in B-TUVP. In catheterized patients, the rate of achieving catheter-free status after surgery was higher in HoLEP than in B-TUVP for patients with PV >80 ml. The incidence of postoperative fever was higher in B-TUVP than in HoLEP for patients with PV 30-80 ml but not for those with PV >80 ml. Conclusions: This is the first retrospective study investigating the short-term efficacy and safety of second-generation B-TUVP in comparison with HoLEP for moderate and large BPE. Improvement in LUTS and achievement of catheter-free status were predominant in HoLEP, and these outcomes were more prominent in patients with large BPE of PV >80 ml. However, B-TUVP resulted in less blood loss, shorter operative duration, and less urinary incontinence suggesting that B-TUVP is also well-tolerated surgical modality.

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Section: Discussionmentioning

confidence: 99%

Comparison of the short-term efficacy and safety of bipolar transurethral electro vaporization and holmium laser enucleation of the prostate for moderate and large benign prostatic enlargement

Hayashi

Yoneyama²,

Takizawa³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Furthermore, the rate of postoperative stress urinary incontinence was significantly higher in HoLEP than in B-TUVP. Transient and mixed urinary incontinence was well-documented as a major complication of HoLEP, with incidence rates at 4.3–16.2% [ 23 – 27 ]. Most case of stress urinary incontinence were reported as transient and, in this study, almost stress urinary incontinence was transient and ceased without any treatment within 6 months.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the short-term efficacy and safety of bipolar transurethral electro vaporization and holmium laser enucleation of the prostate for moderate and large benign prostatic enlargement

Hayashi

Yoneyama²,

Takizawa³

et al. 2023

BMC Urol

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Background To compare the efficacy and safety of bipolar transurethral vaporization of the prostate (B-TUVP) with holmium laser enucleation of the prostate (HoLEP) for moderate [prostate volume (PV) 30–80 ml] and large (≥ 80 ml) benign prostatic enlargement (BPE). Materials and methods Male patients with lower urinary tract symptom (LUTS) or urinary retention who underwent B-TUVP or HoLEP treatment in two regional centers were respectively enrolled. Patient characteristics and treatment outcomes were retrospectively compared between B-TUVP and HoLEP. Results In patients with moderate and large prostate volume,B-TUVP showed shorter operative time (P < 0.001) and less hemoglobin decrease (P < 0.001) than in HoLEP. In uncatheterised patients, voiding symptoms and patients’ quality of life improved after B-TUVP and HoLEP, but these improvement rates were consistently bigger in HoLEP than in B-TUVP. In catheterised patients, the rate of achieving catheter-free status after surgery was higher in HoLEP than in B-TUVP for patients with PV > 80 ml.(P < 0.001) The incidence of postoperative fever was higher in B-TUVP than in HoLEP for patients with PV 30–80 ml (P < 0.001) but not for those with PV > 80 ml.(P=0.08) The Incidence of postoperative stress incontinence(SUI) was higher in HoLEP than in B-TUVP for patients with moderate and large prostate volume. Conclusions There are few studies that investigated the short-term efficacy and safety of second-generation B-TUVP in comparison with HoLEP for moderate and large BPE. Improvement in LUTS and achievement of catheter-free status were predominant in HoLEP, and these outcomes were more prominent in patients with large BPE of PV > 80 ml. However, B-TUVP resulted in less blood loss, shorter operative duration, and less SUI suggesting that B-TUVP is also well-tolerated surgical modality.

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“…Stress urinary incontinence following HoLEP is one of the more frequent postoperative complications, It is transient in about 8% of patients and definitive in about 1.5% [ 16 – 19 ]. It is principally related to prostate volume and the enucleation ratio [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

T-L technique for HoLEP: perioperative outcomes of a large single-centre series

Porreca

Schiavina

Romagnoli

et al. 2021

Cent european J Urol

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Introduction The aim of this article was to describe, step-by-step, an original technique (T-L technique) in a single centre series of patients who underwent holmium laser enucleation of the prostate (HoLEP) for symptomatic benign prostatic hyperplasia and analyze perioperative outcomes. Material and methods We retrospectively analyzed data of 567 patients who underwent HoLEP. The T-L technique consists of a series of incisions used as landmarks, performed at the beginning of the procedure before enucleation. Two T-shape incisions are performed at the level of bladder neck (at the 5-7 and 12 o’clock positions); two L-shape incisions are performed at the level of verumontanum, bilaterally, to mark the apex and to limit the sphincter. Another T-shape incision is performed on the bladder neck at the 12 o’clock position posterior to the level of verumontanum. Results The median operative time (OT) was 80 minutes (IQR 64–105); 50 minutes (IQR 35–70) and 15 minutes (IQR 10–20) for enucleation and the morcellation phase, respectively. Conversion to transurethral resection of the prostate (TURP) was necessary in 3/567 (0.6%) patients. Intraoperative complications occurred in 3.4% of cases, capsule perforation occurred in 12/567 (2%) of cases, while bladder perforation during morcellation occurred in 8/567 (1.4%) of cases. Postoperative complications were observed in 20/567 (3.5%) of patients. Specifically, grade 1–2 occurred in 19/567 (3.3%) and grade 3 was recorded in 1/567 (0.2%). Conclusions The T-L technique for HoLEP is safe and reproducible with a low rate of perioperative complications. The positioning of some landmarks before enucleation allows for the better orientation during enucleation and could be very useful in case of large prostates.

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Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience

Cited by 26 publications

References 27 publications

Comparison of the short-term efficacy and safety of bipolar transurethral electro vaporization and holmium laser enucleation of the prostate for moderate and large benign prostatic enlargement

Comparison of the short-term efficacy and safety of bipolar transurethral electro vaporization and holmium laser enucleation of the prostate for moderate and large benign prostatic enlargement

Comparison of the short-term efficacy and safety of bipolar transurethral electro vaporization and holmium laser enucleation of the prostate for moderate and large benign prostatic enlargement

T-L technique for HoLEP: perioperative outcomes of a large single-centre series

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