Does MOSES Technology Enhance the Efficiency and Outcomes of Standard Holmium Laser Enucleation of the Prostate? Results of a Systematic Review and Meta-analysis of Comparative Studies

Gauhar, Vineet; Gilling, Peter; Pirola, Giacomo Maria; Chan, Vinson Wai-Shun; Lim, Ee Jean; Maggi, Martina; Teoh, Jeremy Yuen‐Chun; Krambeck, Amy E.; Castellani, Daniele

doi:10.1016/j.euf.2022.01.013

Cited by 33 publications

(15 citation statements)

References 18 publications

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“…The data from several clinical studies, in accordance with our results, have concluded that, as a prostate size-independent treatment option, HoLEP is preferable to B-TURP due to a more favorable safety profile, as defined by less bleeding (lower blood transfusions and lower clot retention rates), and a significantly lower drop in hemoglobin level [ 26 , 27 ]…”

Section: Discussionsupporting

confidence: 86%

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B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

et al. 2022

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Background: The aim of this study was to compare the peri-operative and functional results between trans-urethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS) in middle-old patients. Materials and Methods: This prospective single-center study included patients over 75 years old treated with B-TURP or HoLEP for BPH associated with LUTS with prostate volume (PV) <100 mL. Primary endpoints were the intra-operative blood loss, percentage of loss of hemoglobin, blood transfusion, complications, and the comparison of functional outcomes. All patients were evaluated at 1, 3, 6, and 12 months of follow-up. Results: Overall, 96 patients undergoing HoLEP and 104 B-TURP were eligible and enrolled for the study. Post-operative results showed statistically significant differences between the two groups, all in favor of HoLEP group, specifically in terms of removed prostate tissue, PV reduction rate, hemoglobin values at 24 h, hemoglobin loss, operative time, length of hospitalization, days of catheterization, and urinary flow rates. There was no significant difference in terms of postvoid residual urine volume, perioperative complication, blood transfusion, International Prostate Symptom Score (IPSS), and IPSS quality of life scores. Conclusions: In middle-old patients, the HoLEP technique represents a prostate size-independent treatment option with a more favorable safety profile defined by less bleeding, lower blood transfusions, and a significantly lower hemoglobin drop than B-TURP.

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Section: Discussionsupporting

confidence: 86%

“…Our results confirm what has already been reported in the literature in the comparison between the two techniques. However, it should be noted that these results have also been confirmed in elderly patients undergoing BPH surgery [ 27 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 85%

B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

et al. 2022

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“…Across the decades, HoLEP has demonstrated to be a safe technique with low complication rate and is referred to as the gold standard after TURP [ 19 , 20 , 21 ]. Moreover, the advent of MOSES technology can further improve HoLEP outcomes, transforming it to a day surgery procedure [ 22 ]. While HP and MOSES may only be available in referral centers, LP holmium laser machines are universally available, as frequently adopted for other endourological procedures (i.e., lithotripsy).…”

Section: Discussionmentioning

confidence: 99%

Does power setting impact surgical outcomes of holmium laser enucleation of the prostate? A systematic review and meta-analysis

Pirola

Castellani

Maggi

et al. 2022

Cent european J Urol

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Introduction The aim of this article was to enumerate the differences in immediate and postoperative outcomes for holmium laser enucleation of the prostate (HoLEP) performed with low-power (LP) or high-power (HP) laser settings through a systematic review of comparative studies. Material and methods We performed a systematic literature review using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials. Potential clinical differences among LP and HP HoLEP were determined using the PICOS (Patient Intervention Comparison Outcome Study type) model, where outcomes were surgical time, operative efficiency, postoperative catheterization time, length of hospital stay, blood transfusion, incontinence rate, maximum urinary flow rate (QMax) and International Prostatic Symptom score (IPSS). Retrospective, prospective nonrandomized, randomized studies, and meeting abstracts were considered. Results A total of five studies were included for meta-analysis. No significant differences between LP and HP HoLEP were evidenced in terms of intraoperative variables (surgical time, surgical efficiency); postoperative outcomes (length of stay, length of catheterization); postoperative complications; functional results (IPSS; Qmax). Urinary incontinence rate did not differ between the two groups (OR 0.95, 95% CI 0.362.47, p = 0.91). Conclusions The study shows equal outcomes in outcomes from HoLEP performed with LP or HP energy settings. Even if further comparative studies are still needed to increase the level of evidence, those results encourage a further clinical adoption of LP HoLEP.

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“… Reduction of diabetes distress and improvements in the outcome and quality of life of patients with type 2 diabetes mellitus. Supportive of ‘Technology proficiency’ Gauhar et al 2022 20 Benign Prostatic Enlargement (BPE) patients Comparison of perioperative parameters, early outcomes, and complications after Holmium laser enucleation of the prostate (HoLEP) with MOSES technology LEP (MoLEP) for BPE. Moses technology, introduces a pulse-shape modulation for Holmium YAG; optimizing energy transmission to the target tissue, leading to more concise incisions and better coagulation profile.…”

Section: Methodsmentioning

confidence: 99%

“Technology Proficiency” in Medical Education: Worthiness for Worldwide Wonderful Competency and Sophistication

Jain¹,

Jain²,

Jain³

et al. 2022

AMEP

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Purpose Advances in bioinformatics, information technology, advanced computing, imaging techniques are changing fundamentally the way physicians define, diagnose, treat, and prevent disease. New disciplines – Artificial Intelligence, Machine Learning, Computational Biology – are improving healthcare. Digital health solutions have immense scope. Education and practice need to keep pace. Methods We aimed at assessment of “Technology proficiency” required by medical graduates and its implementation, if found useful. All this in a conceptual framework of “TP” model, having categories (a) proper assessment (b) pertinent treatment (c) progress monitoring (d) prevention applications (e) professional standards. A search of the literature was performed using MedLine & Cochrane Central Register of Controlled Trials databases, for systematic reviews and meta-analysis articles published in the last five years using keyword “technology”. Analysis of those relevant to the role all medical graduates should play. An analysis of worldwide statutory medical institutions guidelines. Results Twenty-three systematic studies and meta-analysis were studied. Eighteen show clear evidence for ‘Technology proficiency”, while 5 recommend further studies. The findings are discussed suiting the roles of doctors in the “TP” model. Medical institutions guidelines worldwide diligence suggests need of including “Technology proficiency” as a definite and distinct strategic plan. Medical Council of India mandates “use information technology for appropriate patient care and continued learning”. General Medical Council, UK and Medical Council India have been proactive in technology training. GMC recommends technology use for learning, prescribing, communication, and interpersonal skills. It should be expanding technology proficiency in practice as an essential professional capability. Conclusion “Technology proficiency” is found pertinently fruitful. It should be included as a definitive requirement and a distinct strategic plan worldwide. Modern curriculum development is proposed (i) Educational goals and objectives as the proposed Conceptual framework “Technology proficiency” model (ii) Instructional strategies ‘Five Bs’ (iii) Implementation ‘Five Ms’.

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Does MOSES Technology Enhance the Efficiency and Outcomes of Standard Holmium Laser Enucleation of the Prostate? Results of a Systematic Review and Meta-analysis of Comparative Studies

Cited by 33 publications

References 18 publications

B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

Does power setting impact surgical outcomes of holmium laser enucleation of the prostate? A systematic review and meta-analysis

“Technology Proficiency” in Medical Education: Worthiness for Worldwide Wonderful Competency and Sophistication

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