Anteroposterior Dissection HoLEP: A Modification to Prevent Transient Stress Urinary Incontinence

Endo, Fumiyasu; Shiga, Yoshiyuki; Minagawa, Shingo; Iwabuchi, T; Fujisaki, Akiko; Yashi, Masahiro; Hattori, Kazunori; Muraishi, Osamu

doi:10.1016/j.urology.2010.03.071

Cited by 93 publications

(56 citation statements)

References 12 publications

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“…Surgeries were conducted via anteroposterior dissection [15]. In cases involving hemostatic difficulty, including surgeries conducted by trainees or over a wide hemostatic area, TUC with an electric current was used for hemostasis.…”

Section: Methodsmentioning

confidence: 99%

“…In cases involving hemostatic difficulty, including surgeries conducted by trainees or over a wide hemostatic area, TUC with an electric current was used for hemostasis. Morcellation was performed using the inverse technique [15,24]. A total of 14 operators performed surgeries.…”

Section: Methodsmentioning

confidence: 99%

“…Continued UI after prostate surgery has been reported to deteriorate a patient's health-related quality of life (QOL), as measured by instruments such as the EuroQOL-5 Dimension and Short Form 12-Item Survey [11]; accordingly, UI after HoLEP is thought to similarly influence the health-related QOL. Some reports have described the preoperative prognosticators of post-HoLEP UI [12,13,14] and have devised procedures to prevent this complication [15]. However, it is challenging to address this issue because many patients are poorly compliant after surgery (i.e., do not regularly visit hospitals); additionally, no sufficient evaluation method has been established because of the lack of a clear and unified standard, in contrast to the post-surgical follow-up procedures for cases involving malignant diseases such as prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

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Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Fujisaki

Goto²,

Endo³

et al. 2016

Urol Int

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Introduction: Epidemiological data regarding complications after holmium laser enucleation of the prostate (HoLEP) are scarce in Japan. We examined the associations of the 24-hour pad test results immediately after HoLEP with continence acquisition at 3 months postoperatively. Materials and Methods: In this hospital-based case-series study, we reviewed medical charts of 341 patients without catheterization and 150 patients with catheterization at the time of surgery. The 24-hour pad test was conducted immediately after catheter removal to measure the leakage weight. Subjects were divided into 2 groups: leakage weight = 0 g (negative) and >0 g (positive). Urinary incontinence (UI) at 3 months postoperatively was self-reported by patients. Results: Significant relationships were observed between pad test positivity and UI at 3 months postoperatively and between the pad test weight and the timing of continence acquisition in patients with and without catheterization. In multivariate analyses, the pad test positivity was associated significantly with the Overactive Bladder Symptom Score and enucleated tissue weight in patients without perioperative catheterization and with age in patients with catheterization. Conclusions: The 24-hour pad test immediately after catheter removal could indicate the need for early and active intervention to prevent continuous postoperative UI. Patients' symptoms and clinical items predictive of test positivity should be carefully assessed.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Fujisaki

Goto²,

Endo³

et al. 2016

Urol Int

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“…This result indicated technical improvement possibly contributes to reduce postoperative UI. Indeed, Endo et al (19) revealed that the procedure of anteroposterior dissection (a surgical procedure where adenoma is dissected antegradely) could decrease postoperative stress UI. Further studies are warranted to assess the association between surgical technique and postoperative UI.…”

Section: Commentsmentioning

confidence: 99%

Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period

Kobayashi¹,

Yano²,

Nakayama³

et al. 2016

Int. braz j urol.

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Purpose:To determine the predictive factors for postoperative urinary incontinence (UI) following holmium laser enucleation of the prostate (HoLEP) during the initial learning period.Patients and Methods:We evaluated 127 patients with benign prostatic hyperplasia who underwent HoLEP between January 2011 and December 2013. We recorded clinical variables, including blood loss, serum prostate-specific antigen levels, and the presence or absence of UI. Blood loss was estimated as a decline in postoperative hemoglobin levels. The predictive factors for postoperative UI were determined using a multivariable logistic regression analysis.Results:Postoperative UI occurred in 31 patients (24.4%), but it cured in 29 patients (93.5%) after a mean duration of 12 weeks. Enucleation time >100 min (p=0.043) and blood loss >2.5g/dL (p=0.032) were identified as significant and independent risk factors for postoperative UI.Conclusions:Longer enucleation time and increased blood loss were independent predictors of postoperative UI in patients who underwent HoLEP during the initial learning period. Surgeons in training should take care to perform speedy enucleation maneuver with hemostasis.

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“…Other studies argued that diabetes mellitus, large prostate volume and a greater reduction in postoperative prostate‐specific antigen (>84% remained) are significant risk factors for stress UI . As another main mechanism, there are reports that resection of adenoma tissue close to the external sphincter might cause temporary UI …”

Section: Post‐holep Uimentioning

confidence: 99%

Current status of holmium laser enucleation of the prostate

Shigemura

Fujisawa

2017

Int J of Urology

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There are several options for the surgical management of benign prostatic hyperplasia representatively from transurethral resection of the prostate. Holmium laser enucleation of the prostate is one of those options, and many institutions and urologists have initiated this technique, and most of them have accomplished better outcomes compared with transurethral resection of the prostate. In contrast to transurethral resection of the prostate, which requires a similar procedure to transurethral resection of bladder tumors, holmium laser enucleation of the prostate requires a special surgical technique: enucleation and morcellation with around 10 years' history of experience, even in Japan. The present review introduces the current status of holmium laser enucleation of the prostate, so that it surely contributes to the knowledge of International Journal of Urology readers who could be experienced surgeons or beginners as well.

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Anteroposterior Dissection HoLEP: A Modification to Prevent Transient Stress Urinary Incontinence

Cited by 93 publications

References 12 publications

Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal

Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period

Current status of holmium laser enucleation of the prostate

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