Holmium Laser Enucleation of Prostate Within 6 Weeks of Transrectal Ultrasound Guided Prostate Biopsy is Safe and Effective

Etafy, Mohamed; Katz, Jonathan E.; Gonzalgo, Mia R; Lopez, Emmanuel Alejandro Garcia; Shah, Rashmi; Banerjee, Indraneel; Smith, Nicholas A.; Shah, Hemendra N.

doi:10.1016/j.urology.2020.11.021

Cited by 7 publications

(2 citation statements)

References 11 publications

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“…However, data on the surgical outcomes of HoLEP performed after a prostate biopsy are limited, as the number of preoperative biopsies and HoLEPs performed is not sufficient to accurately predict the results. Yıldız et al [ 28 ] and Etafy et al [ 29 ] have reported no significant difference between the TR and non-TR biopsy groups regarding perioperative complications, postoperative voiding outcomes, or rate of incidental prostate cancer detection. However, Piazza et al [ 30 ] have reported that the time from TR biopsy to HoLEP of ≤6 months is associated with a higher risk of intraoperative complications, lower enucleation efficacy, and longer enucleation time.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome and safety of holmium laser prostate enucleation after transrectal prostate biopsies for benign prostatic hyperplasia

Choi,

Kang,

Kim

et al. 2024

Investig Clin Urol

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Purpose This study aimed to assess the clinical outcome and safety of holmium laser enucleation of the prostate (HoLEP) following transrectal ultrasound-guided prostate biopsy (TR biopsy) in the treatment of benign prostate hyperplasia. Materials and Methods We retrospectively analyzed data from 556 patients who underwent HoLEP between 2014 and 2021. The patients were categorized into six groups: Group 1-A (n=45) underwent HoLEP within four months post TR biopsy. Group 1-B (n=94) underwent HoLEP more than four months post TR biopsy. Group 1-C (n=120) underwent HoLEP after a single TR biopsy. Group 1-D (n=19) underwent HoLEP after two or more TR biopsies. Group 1-total (n=139, group 1-A+group 1-B or group 1-C+group 1-D) underwent HoLEP post TR biopsy. Group 2 (control group, n=417) underwent HoLEP without prior TR biopsy. We examined perioperative parameters, safety, and functional outcomes. Results The age, body mass index, International Prostate Symptom Score (IPSS), uroflowmetry, and comorbid diseases between group 1-total and group 2 were comparable. However, group 1-total exhibited significantly elevated prostate-specific antigen levels and larger prostate volumes (p<0.01). Perioperative factors like enucleation time, enucleation weight, and catheterization duration were notably higher in group 1-total (p<0.01). All groups showed significant improvements in IPSS, postvoid residual urine, and maximum flow rate during the 1-year postoperative period (p<0.05). The rates of postoperative complications were similar between group 1-total and group 2. Conclusions Enucleation time and catheterization duration were significantly longer in the TR biopsy group. However, postoperative complications were not significantly different between TR biopsy and non-TR biopsy groups.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome and safety of holmium laser prostate enucleation after transrectal prostate biopsies for benign prostatic hyperplasia

Choi,

Kang,

Kim

et al. 2024

Investig Clin Urol

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“…showed that holmium laser enucleation of the prostate (HoLEP) performed within 6 weeks after transrectal ultrasound (TRUS)-guided prostate biopsy had no negative impact on the outcome of the procedure [7]. A prospective study by El-Hakim and Elhilali showed that HoLEP takes longer to train than standard TURP and has a steeper learning curve.…”

Section: H Xie Et Almentioning

confidence: 99%

Advances in Minimally Invasive Treatment of Benign Prostatic Hyperplasia

Xie¹,

Liu²,

Zheng³

2022

JBM

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Benign prostatic hyperplasia (BPH) is a chronic condition that is more common in older men. BPH most commonly causes symptoms associated with LUTS and bladder outlet obstruction. Lower urinary tract symptoms (LUTS) in men with BPH are a major cause of reduced quality of life in older men. If bladder outlet obstruction persists for a longer period of time, the contractility and voiding capacity of the detrusor muscle will gradually be affected by the obstructive factors, eventually leading to a loss of compensatory phase, characterised by a reduced electrical stimulation response, replacement of bladder muscle tissue by connective tissue, and a possible increase in voiding pressure, but a decrease in contractility of the detrusor muscle. As BOO progresses, it eventually leads to permanent contractile dysfunction of the detrusor muscle. Therefore, early initiation of surgical treatment in patients who are not well controlled by medication can reduce the complications associated with prostate enlargement. With the rise of minimally invasive treatment and the complications of open surgery, minimally invasive treatment of BPH has attracted increasing attention. Various emerging minimally invasive surgical modalities are being developed in clinical practice, and more and more minimally invasive techniques and concepts are focusing on safety, improving quality of life and reducing long-term complications to meet the different needs of different patients. Transurethral resection of the prostate (TURP) is currently the "gold standard" of minimally invasive surgical treatment, but with concerns about post-operative complications, the search for safer and more effective minimally invasive surgical options has become even more important. In recent years, with the increasing clinical application of new minimally invasive techniques such as various lasers, interventional treatments and implantable devices, there are more options for minimally invasive treatment of BPH. This article provides a brief review of research advances in the minimally invasive treatment of benign prostatic hyperplasia, with a view to informing clinical decisions.

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Factors predicting indistinct plane of surgical capsule in patients underwent HoLEP procedures

Liu,

Zhao,

Xiao

et al. 2024

World J Urol

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Holmium Laser Enucleation of Prostate Within 6 Weeks of Transrectal Ultrasound Guided Prostate Biopsy is Safe and Effective

Cited by 7 publications

References 11 publications

Clinical outcome and safety of holmium laser prostate enucleation after transrectal prostate biopsies for benign prostatic hyperplasia

Clinical outcome and safety of holmium laser prostate enucleation after transrectal prostate biopsies for benign prostatic hyperplasia

Advances in Minimally Invasive Treatment of Benign Prostatic Hyperplasia

Factors predicting indistinct plane of surgical capsule in patients underwent HoLEP procedures

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