Holmium laser enucleation of the prostate combined with mechanical morcellation in 155 patients with benign prostatic hyperplasia

Hurle, Rodolfo; Vavassori, Ivano; Piccinelli, Alessandro; Manzetti, Alberto; Valenti, Sergio; Vismara, Alberto

doi:10.1016/s0090-4295(02)01812-5

Cited by 56 publications

(25 citation statements)

References 15 publications

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“…Therefore, meticulous bleeding control before morcellation is necessary, and the bladder should be expended sufficiently during the morcellation to prevent mucosal injury [26]. The aforementioned measurements of the bladder neck obtained with a cystoscope are also helpful to localize the blade at the proper depth; the morcellator should not be manipulated when the blade is not along the midline.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of holmium laser enucleation of the prostate for extremely large prostatic adenoma in patients with benign prostatic hyperplasia

et al. 2015

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PurposeTo evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for extremely large prostates.Materials and MethodsPatients undergoing HoLEP between July 2008 and December 2013 from the Seoul National University Hospital Benign Prostatic Hyperplasia Database Registry were retrospectively analyzed. The patients were divided into three groups according to their total prostate volume (TPV): group A (TPV<100 mL), group B (100 mL≤TPV<200 mL), and group C (TPV≥200 mL); the clinical data of the three groups were compared. All patients were followed up 2 weeks, 3 months, and 6 months after surgery.ResultsA total of 502 patients (group A, 426; group B, 70; group C, 6) with a mean age of 69.0 (standard deviation, ±7.3) years were included in our analysis. The mean prostate volume and prostate-specific antigen level were 68.7±36.9 mL and 4.15±4.24 ng/mL, respectively. The enucleation and morcellation times were longer in group C (p<0.001), and the enucleation efficacy was higher in this group (p<0.001, R2=0.399). Moreover, the mean postoperative catheterization and hospitalization periods were significantly longer in group C (p=0.004 and p=0.011, respectively). However, there were no significant differences between the groups in any other postoperative events, including recatheterization, reoperation, urinary tract infection, clot retention, and bladder neck contracture (p range, 0.516-0.913). One patient in group C experienced recurrence of the urethral stricture.ConclusionsHoLEP in patients with an extremely large prostate can be performed efficiently and safely.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of holmium laser enucleation of the prostate for extremely large prostatic adenoma in patients with benign prostatic hyperplasia

et al. 2015

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“…Compared with TURP, HoLEP leads to similar clinical outcomes. Hurle et al [28] treated 155 consecutive men with a mean prostate volume of 53 ± 39 G and reported significant improvements in symptom score, quality-of-life score, and peak urinary flow rate. Mean operative time was 87 ± 44 minutes with a resected weight of 37 ± 26 G. None of the patients required a transfusion or had hyponatremia.…”

Section: Resultsmentioning

confidence: 99%

Laser therapy for the treatment of benign prostatic hyperplasia: A review

Kim

Altunrende

2003

Curr prostate rep

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“…The size of the prostate gland has not been shown to have a negative impact on the efficiency of HoLEP in the hands of experienced urologists [9]. The rate of complications drops as the number of operations performed by the primary surgeon increases.…”

Section: Discussionmentioning

confidence: 99%

Acute abdominal compartment syndrome as a complication of Holmium laser enucleation of the prostate: a case report

Richter

Huebler

2014

BMC Anesthesiol

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BackgroundIn 1996, Holmium laser enucleation of the prostate was introduced and has been shown to be safe and highly effective.Case presentationWe report a case of a rare complication that resulted in intra-abdominal compartment syndrome with prolonged intubation and intensive care, involving an 74-year-old male after holmium laser enucleation of prostate, with a massive irrigant fluid leakage into the retroperitoneal space. The elevated abdominal pressure was reduced by forced diuresis. The tracheal tube was removed 18 hours after the patient’s transfer to the ICU. The patient was discharged to home one week after the operation.ConclusionIn rare cases when no obvious ruptures of the prostate capsule or the bladder occur during laser enucleation of prostate, knowledge regarding possible emersion of massive amounts of irrigant fluid into the retroperitoneal space leading to intra-abdominal compartment syndrome aids in the diagnosis and subsequent successful therapy of intra-abdominal hypertension.

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Holmium laser enucleation of the prostate combined with mechanical morcellation in 155 patients with benign prostatic hyperplasia

Cited by 56 publications

References 15 publications

Efficacy and safety of holmium laser enucleation of the prostate for extremely large prostatic adenoma in patients with benign prostatic hyperplasia

Efficacy and safety of holmium laser enucleation of the prostate for extremely large prostatic adenoma in patients with benign prostatic hyperplasia

Laser therapy for the treatment of benign prostatic hyperplasia: A review

Acute abdominal compartment syndrome as a complication of Holmium laser enucleation of the prostate: a case report

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