Does Holmium laser enucleation of the prostate (HoLEP) still have a steep learning curve? Our experience of 100 consecutive cases from Turkey

Gürlen, Güçlü; Karkin, Kadir

doi:10.4081/aiua.2021.4.412

Cited by 10 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The HoLEP procedure has comparable results to transurethral resection of the prostate (TURP) and OP, with a low morbidity rate and shorter hospital stay (2)(3)(4)(5)(6). HoLEP also demonstrated an acceptable steep learning curve (7). Improvements in outcome parameters following HoLEP are durable, and the late complications and reoperation rates reported are very low, up to 18 years (8).…”

mentioning

confidence: 99%

Comparative analysis of MOSES<sup>TM</sup> technology versus novel thulium fiber laser (TFL) for transurethral enucleation of the prostate: A single-institutional study

Elmansy

Hodhod

Elshafei

et al. 2022

Arch Ital Urol Androl

View full text Add to dashboard Cite

Introduction: Novel laser technologies have been developed for the minimally invasive surgical management of benign prostatic hyperplasia (BPH). The objective of this study was to assess the safety and efficacy of MOSESTM technology versus the thulium fiber laser (TFL) in patients with BPH undergoing transurethral enucleation of the prostate. Methods: We conducted a retrospective review of prospectively collected data of eighty-two patients who underwent transurethral enucleation of the prostate using MOSESTM or TFL technologies from August 2020 to September 2021. Preoperative and intraoperative parameters, in addition to postoperative outcomes, were collected and analyzed. Results: Twenty patients underwent transurethral enucleation of the prostate with TFL, while 62 had MOSESTM HoLEP. No statistically significant difference in preoperative characteristics was observed between the groups. Patients in the TFL group had longer median enucleation, hemostasis, and morcellation times (p < 0.001) than those in the MOSESTM cohort. The longer morcellation time of TFL is mostly related to less visibility. The postoperative outcomes IPSS, QoL, Qmax, and post void residual (PVR), were comparable between the groups at 1, 3 and 6 months. The incidence of urge urinary incontinence (p = 0.79), stress urinary incontinence (p = 0.97), and hospital readmission rates (p = 0.1) were comparable between the two groups. Conclusions: A satisfactory safety and efficacy profile with comparable postoperative outcomes was demonstrated for both techniques; though, MOSESTM technology was superior to TFL in terms of shorter overall operative time.

show abstract

mentioning

confidence: 99%

Comparative analysis of MOSES<sup>TM</sup> technology versus novel thulium fiber laser (TFL) for transurethral enucleation of the prostate: A single-institutional study

Elmansy

Hodhod

Elshafei

et al. 2022

Arch Ital Urol Androl

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that performing TUEP during the learning curve led to satisfactory results, even without mentors. It was estimated that about 25-50 operations were needed, with a slightly steeper learning curve when using Holmium laser instead of bipolar current [21][22][23][24][25]. With this information in mind, none of the surgeons had progressed past the learning curve at the time this study was conducted.…”

Section: Discussionmentioning

confidence: 99%

Transurethral versus open enucleation of the prostate in Sweden – a retrospective comparative cohort study

Bohlok,

Söderberg,

Patschan

2023

SJU

View full text Add to dashboard Cite

Objective: To investigate if treatment with transurethral enucleation of the prostate (TUEP) during the learning curve is as efficient and safe in the short term as transvesical open prostate enucleation (OPE), in patients with benign prostatic obstruction (BPO) > 80 ml in a population in Sweden. Methods: 54 patients with ultrasound verified BPO > 80 ml and indication for surgery underwent TUEP or OPE between 2013 and 2019. Peri- and postoperative outcome variables regarding voiding efficiency and morbidity from 20 OPE at Skåne University Hospital (SUS) and from the first 34 TUEP performed at SUS and Ystad Hospital were retrospectively assembled. Follow-up data from the first 6 postoperative months were collected by chart review. Results: Intraoperative bleeding during TUEP was less than in OPE (225 ml vs. 1,000 ml). TUEP took longer surgery time than OPE (210 vs. 150 min.). Within 30 days postoperatively, bleeding occurred less often after TUEP (23% vs. 40%), requiring one fourth of the blood transfusions given after OPE. After TUEP, patients had shorter hospitalisation (3 days vs. 7 days) and catheterisation time (3 days vs. 12 days). During the 6-month follow-up period, incontinence and UTI defined as symtomatic significant bacteriuria (urinary culture) were observed as main complications after TUEP and OPE. Functional outcome data availability (International Prostate Symptom Score [IPSS] questionnaire, uroflowmetry, residual urine) were limited. Conclusions: Treatment with TUEP during the learning curve led to less bleeding, shorter hospitalisation- and catheterisation time than treatment with OPE. However, surgery time was shorter with OPE. There were no major differences between the groups concerning mid-term functional outcomes, with the reservation of an inconsistent follow-up.

show abstract

“…[ 11 ] This may be in part due to the technical difficulty of HoLEP as was demonstrated by a recent study which showed that a learning curve of 40–60 cases is required for stability of performance, another analysis showed that only 25–50 is enough. [ 12 13 ] In addition, there may be some financial issues in the form of the unavailability of a morcellator or laser energy source as well as this option may not be adequately reimbursed. [ 14 15 ]…”

Section: Introductionmentioning

confidence: 99%

Early experience of “En bloc” holmium laser enucleation of the prostate in Saudi Arabia

Alharbi,

Alshamsan,

Almansour

et al. 2024

Urology Annals

View full text Add to dashboard Cite

Purpose: Holmium laser enucleation of the prostate (HoLEP) showed higher efficacy than transurethral resection for treating benign prostatic hyperplasia (BPH). The present study aims to report the outcome of BPH treatment by HoLEP in a tertiary center. Patients and Methods: An observational prospectively collected data for consecutive symptomatic BPH patients undergoing HoLEP between January 2020 and December 2021. Demographic and perioperative data were collected with the International Prostate Symptom Score (IPSS), quality of life, peak flow rate (Qmax), residual urine postvoid residual (PVR), and prostate-specific antigen (PSA) changes, in addition to perioperative and late adverse events. Results: One hundred patients were included with a median age of 73 years (range 65–80). The IPSS improved by 80% postoperatively (25 vs. 5, P < 0.001). Similarly, Qmax significantly improved. Seven patients were found to have incidental prostate cancer. No patient needed a perioperative blood transfusion. Compared to its preoperative values, follow-up PSA has been reduced by 75% (P < 0.001). Urethral stricture and bladder neck contracture were noted in < 2% of the patients. Conclusions: HoLEP is feasible for all prostate sizes and a safe and effective treatment for BPH patients; our results are consistent with the reported data in the literature regarding functional outcomes, complication rates, and urinary incontinence rates.

show abstract

Does Holmium laser enucleation of the prostate (HoLEP) still have a steep learning curve? Our experience of 100 consecutive cases from Turkey

Cited by 10 publications

References 29 publications

Comparative analysis of MOSES<sup>TM</sup> technology versus novel thulium fiber laser (TFL) for transurethral enucleation of the prostate: A single-institutional study

Comparative analysis of MOSES<sup>TM</sup> technology versus novel thulium fiber laser (TFL) for transurethral enucleation of the prostate: A single-institutional study

Transurethral versus open enucleation of the prostate in Sweden – a retrospective comparative cohort study

Early experience of “En bloc” holmium laser enucleation of the prostate in Saudi Arabia

Contact Info

Product

Resources

About