Current status of holmium laser enucleation of the prostate

Shigemura, Katsumi; Fujisawa, Masato

doi:10.1111/iju.13507

Cited by 22 publications

(10 citation statements)

References 70 publications

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“…HoLEP has been described as the emerging gold standard for BPH surgical management in the twentyfirst century however the implementation of this surgical technique faces the obstacle of a steep learning curve (68,69). Today, with many institutions having at least 10 years of training and experience with HoLEP, the procedure appears to be a viable and effective treatment for BPH (70). However, the difficulty of performing HoLEP still bars its use in many smaller or referral centers.…”

Section: Holmium Laser Enucleation Of the Prostate (Holep)mentioning

confidence: 99%

Epidemiology and treatment modalities for the management of benign prostatic hyperplasia

Lokeshwar¹,

Harper²,

Webb³

et al. 2019

Transl. Androl. Urol.

160

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Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting men. BPH can lead to a number of symptoms for patients commonly referred to as lower urinary tract symptoms (LUTS).Over the last decade, increased modifiable risk factors, such as metabolic disease and obesity, have resulted in an increased incidence of BPH. This increasing incidence has brought about a multitude of treatment modalities in the last two decades. With so many treatment modalities available, physicians are tasked with selecting the optimal therapy for their patients. Current therapies can first be divided into medical or surgical intervention. Medical therapy for BPH includes 5-alpha-reductase inhibitors and alpha-blockers, or a combination of both. Surgical interventions include a conventional transurethral resection of the prostate (TURP), as well as newer modalities such as bipolar TURP, holmium laser enucleation of the prostate (HoLEP), Greenlight and thulium laser, and prostatic urethral lift (PUL). Emerging therapies in this field must also be further investigated for safety and efficacy. This narrative review attempts to consolidate current and emerging treatment options for BPH and highlights the need for additional investigation on optimizing treatment selection.

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Section: Holmium Laser Enucleation Of the Prostate (Holep)mentioning

confidence: 99%

Epidemiology and treatment modalities for the management of benign prostatic hyperplasia

Lokeshwar¹,

Harper²,

Webb³

et al. 2019

Transl. Androl. Urol.

160

View full text Add to dashboard Cite

show abstract

“…Compared with TURP, there is no difference in the outcome of surgical treatment. Although initially described as an alternative to TURP, the HoLEP procedure has great potential to become a "volume-independent," new gold standard in the surgical treatment of BPH (21)(22)(23)(24).…”

Section: Holmium Laser Enucleation Of the Prostate (Holep)mentioning

confidence: 99%

Laser Therapy for Benign Prostatic Hyperplasia: Physical Basics and Current Status

2022

Предизвици Во Хирургијата На Урогениталниот Систем, Трансплантацијата И Медицината

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Introduction: Contemporary laser technologies in urology are becoming a new gold standard and a necessary tool for minimally invasive treatment of benign prostatic hyperplasia (BPH). Advances in laser technology applied to the treatment of BPH have been inspired primarily by the need to find a comparable alternative therapeutic option to transurethral resection of the prostate (TURP) and open prostatectomy (OP).Material and methods: Laser procedures for BPH encompasses a variety of laser types and operative techniques, including visual laser ablation of the prostate (VLAP), transurethral ultrasound guided laser incision prostatectomy (TULIP), potassium titanyl phosphate (KTP) laser, contact laser vaporization of the prostate (CLV), interstitial laser coagulation (ILC), holmium laser resection of the prostate (HoLRP), holmium laser enucleation of the prostate (HoLEP), holmium laser ablation of the prostate (HoLAP) and thulium laser (vapo)enucleation or resection. Each of these techniques has certain advantages and disadvantages, both when compared with each other, and when compared to TURP.Results: Modern lasers have far greater energy power compared with the older generations of lasers, and these modern lasers are used in surgery for precise cutting, evaporation and tissue coagulation. The effect of the laser depends on the wavelength as well as on the ability of the target tissue to absorb radiation energy. Thus, to choose the best laser for a given type of surgery, one should keep in mind the differences between lasers, the variability of their use, and the factors that determine how the laser affects the tissue. The aspirations of this study were aimed at creating innovative procedures, which would not have limitations in terms of prostate volume and whose clinical results related to perioperative morbidity, hemorrhage and hospitalization period would be at least identical to the clinical results achieved by the TURP and OP.Conclusions: Traditional operating techniques are slowly becoming a thing of the past, and classical methods are being replaced by technological innovations, primarily advanced lasers. Among the many types of lasers used for the surgical treatment of BPH, the holmium and thulium lasers are currently the most widely used in clinical practice.

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“…Moreover, it may be challenging to identify and coagulate the source of the bleed. While the Ho:YAG laser's hemostatic ability is appropriate in the enucleation of the prostate [5], the upper tract offers a smaller working space, making a laser with improved hemostasis a more ideal option. The T-1470 LiteTouch™ Laser's size, precision, tissue absorptive capacity, and strong hemostatic potential offer ideal characteristics to perform this surgery.…”

Section: Case Reports In Urologymentioning

confidence: 99%

Use of the T-1470 LiteTouch™ Laser in the En Bloc Resection of an Upper Tract Urothelial Cancer

Shoen

Zollinger

Gresham

et al. 2021

Case Reports in Urology

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Background. Endoscopic laser-ablative therapy of upper tract urothelial carcinoma offers kidney-sparing treatment for well-selected low-risk tumors. The traditional technique consists of tumor biopsy with flexible forceps or nitinol basket for pathologic assessment of stage and grade, followed by laser ablation of the tumor. In this case, we present the use of the new T-1470 LiteTouch™ laser for intraoperative tumor en bloc resection, affording both tissue acquisition and tumor ablation. Case Presentation. An 81-year-old female with a past medical history significant for stage 4 chronic kidney disease, peripheral artery disease, coronary artery disease, type 2 diabetes mellitus, and gout was diagnosed with a 2 cm left upper tract high-grade papillary urothelial carcinoma confirmed by cytology with cell block preparation. Using a novel approach, the tumor was resected, en bloc, using the T-1470 LiteTouch™ laser which allowed for sufficient tissue resection for pathologic examination and strong hemostasis. This new technique is the first recorded example of tumor en bloc resection using the T-1470 LiteTouch™ laser of an upper tract urothelial carcinoma. Conclusion. The use of the T-1470 LiteTouch™ laser offers promise for its use as a novel laser for the endoscopic treatment of upper tract urothelial carcinoma. It shows potential for advantages over current techniques through its ability to achieve en bloc resection and superior hemostasis.

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Current status of holmium laser enucleation of the prostate

Cited by 22 publications

References 70 publications

Epidemiology and treatment modalities for the management of benign prostatic hyperplasia

Epidemiology and treatment modalities for the management of benign prostatic hyperplasia

Laser Therapy for Benign Prostatic Hyperplasia: Physical Basics and Current Status

Use of the T-1470 LiteTouch™ Laser in the En Bloc Resection of an Upper Tract Urothelial Cancer

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