A Feasibility Study Utilizing the Thulium and Holmium Laser in Patients for the Treatment of Recurrent Benign Prostatic Hyperplasia after Previous Prostatic Surgery

Becker, Benedikt; Netsch, Christopher; Glybochko, Petr; Rapoport, L.; Taratkin, Mark; Enikeev, Dmitry

doi:10.1159/000489858

Cited by 19 publications

(37 citation statements)

References 24 publications

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“…Kuntz et al [17] reported a transfusion requirement rate of 0% in their HoLEP group and 13.3% in their OPS group (p = 0.003). In addition, laser methods including HoLEP can be safely applied in patients with previous prostate surgery due to BPH [22]. In our study, no statistically significant difference in complications was observed between patients with ≤80-mL PVs (Group 1) and those with > 80-mL PVs (Group 2).…”

Section: Discussionmentioning

confidence: 48%

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Gazel

Kaya²,

Yalçın³

et al. 2019

Urol Int

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Introduction: Holmium laser enucleation of the prostate (HoLEP) is becoming the new standard procedure for treating benign prostatic hyperplasia (BPH), a common condition in aging men. Most studies have focused on proving its efficacy in treating large prostates. In this study, we compared its efficacy in treating small (< 80 mL) and large (> 80 mL) prostates. Methods: This prospective study included 119 patients with BPH who underwent HoLEP by the same surgeon between June 2015 and December 2017. They were divided into 2 groups according to their prostate volumes (≤80 mL: Group 1; > 80 mL: Group 2). Various pre- and postoperative parameters were compared within and between the groups. Results: International Prostate Symptom Score (IPSS), postvoid residual (PVR) volume, and voiding time (VT) significantly decreased, and the peak urinary flow rate (Qmax), average urinary flow rate (Qave), and quality of life (QoL) score significantly increased postoperatively in both groups. The postoperative changes in IPSS, QoL score, Qmax, Qave, VT, PVR volume, and hemoglobin levels were not significantly different between the groups. In addition, no significant difference was observed in postoperative complications between the groups. Conclusions: Our results indicate that HoLEP is an effective procedure for treating both small and large prostates.

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Section: Discussionmentioning

confidence: 48%

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Gazel

Kaya²,

Yalçın³

et al. 2019

Urol Int

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“…HoLEP represented a paradigm change in the surgical management of BPH even for recurrent cases [9]. The pulsed nature of the holmium laser facilitates a clearer enucleation plane to follow and enables superior visibility than the other types of lasers.…”

Section: Discussionmentioning

confidence: 99%

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

et al. 2019

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Introduction: The DrillCut^TM morcellator is marketed for its fast and highly efficient removal of prostatic tissue and a higher level of patient safety. However, a paucity of publications has looked into its actual efficacy and safety. The aim of our study was to evaluate its ex vivo and in vivo efficiency and to compare its results with other devices presented in the literature. Patients and Methods: We conducted a prospective pilot study on patients who underwent holmium laser enucleation of the prostate (HoLEP) from 2017 to 2018 using the Top-Down technique. Enucleated adenomas were morcellated using the DrillCut^TM morcellator. We collected both preoperative and operative data. Operative data included the enucleated adenoma weight and operative time. Various morcellator parameters were collected including morcellation time and efficiency. We recorded the encountered complications and device malfunction. Ex vivo characteristics were evaluated in terms of morcellation speed and aspiration power. Results: Sixty consecutive patients with a median age of 72.8 years were included. The enucleated adenoma was retrieved in 12.5 min (4–58). The median resected prostatic weight was 90 g (44–242). The DrillCut^TM efficiency was calculated as 6.46 g/min (2.7–15). Only one patient had a simple bladder mucosal injury. Device malfunction was encountered in 4 patients (6.6%) due to blockage of the morcellator blades. The ex vivo aspiration speed was 52 s/L, while the morcellation power was 14 g/2 min. Conclusion: Our results showed that the DrillCut morcellator was effective and safe in managing our patients post-HoLEP. The DrillCut^TM has better ex vivo morcellation power but modest aspiration speed in comparison to other morcellators.

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“…The results of recent meta-analyses and systematic reviews show endoscopic enucleation to be highly efficacious in the treatment of BPH, and to have comparable postoperative outcomes to TURP [ 12 – 14 ]. Both techniques are very effective regarding IPSS and Qmax outcomes, however, the effect of surgical treatment of benign prostatic enlargement (BPE) on EF after surgery remain the subject of discussion amongst Urologists.…”

Section: Discussionmentioning

confidence: 99%

Impact of endoscopic enucleation of the prostate with thulium fiber laser on the erectile function

et al. 2018

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BackgroundThe impact of number of endoscopic enucleation of the prostate techniques (holmium laser enucleation - HoLEP for example) on erectile function have already been investigated. However, the thulium-fiber laser, in this setting remains unstudied. In this study, we compared sexual function outcomes in patients with benign prostatic hyperplasia (BPH) treated with transurethral resection of the prostate (TURP) or thulium-fiber laser enucleation (ThuFLEP).MethodsWe performed a retrospective analysis of patients who underwent transurethral resection and endoscopic enucleation of the prostate for BPH; inclusion criteria was the presence of infravesical obstruction (IPSS > 20, Qmax < 10 mL/s). Erectile function (EF) was assessed using the International Index of Erectile Function (IIEF-5) both prior to endoscopic examination, and six months after.ResultsA total of 469 patients with BPH were included in the study; of these, 211 underwent to ThuFLEP, and 258 TURP. Preoperative IIEF-5 in TURP and ThuFLEP groups were 11.7 (±4.5) and 11.1 (±5.0), respectively (p = 0.17). At six month the IIEF-5 score was unchanged (p = 0.26 and p = 0.08) and comparable in both groups (p = 0.49). However, mean IIEF-5 score shown significant increase of 0.72 in ThuFLEP group, comparing to decrease of 0.24 in TURP patients (p < 0.001).ConclusionsBoth TURP and ThuFLEP are effective modalities in the management of infravesical obstruction due to BPH. At six months follow-up after surgery, both techniques lead to comparable IIEF-5 score. However, our results demonstrated that the ThuFLEP is more likely to preserve the erectile function leading to increase of IIEF-5 at six months in contrast to TURP which lead to slight drop in IIEF-5 score.

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A Feasibility Study Utilizing the Thulium and Holmium Laser in Patients for the Treatment of Recurrent Benign Prostatic Hyperplasia after Previous Prostatic Surgery

Cited by 19 publications

References 24 publications

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

Impact of endoscopic enucleation of the prostate with thulium fiber laser on the erectile function

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A Feasibility Study Utilizing the Thulium and Holmium Laser in Patients for the Treatment of Recurrent Benign Prostatic Hyperplasia after Previous Prostatic Surgery

Cited by 19 publications

References 24 publications

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and &#x3e; 80 mL

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and &#x3e; 80 mL

The ex vivo and in vivo Characteristics of New DrillCut<sup>TM</sup> Prostate Morcellator after Holmium Laser Enucleation of the Prostate: A Pilot Study

Impact of endoscopic enucleation of the prostate with thulium fiber laser on the erectile function

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Product

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Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL

Comparison of the Efficacy of Holmium Laser Enucleation of the Prostate in Treating Prostate Volumes of ≤80 and > 80 mL