Low-Power Vs High-Power Holmium Laser Enucleation of the Prostate: Critical Assessment through Randomized Trial

Elshal, Ahmed M.; El-Nahas, Ahmed R.; Ghazy, Mostafa; Nabeeh, Hossam; Laymon, Mahmoud; Soltan, Mohamed A.; Ghobrial, Fady K.; El‐Kappany, Hamdy A.

doi:10.1016/j.urology.2018.07.010

Cited by 29 publications

(25 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Infection is another common adverse event during transurethral surgery. Postoperatively, especially for the patients with small glands, inflammatory stenosis is prevalent in the prostatic urethra, which can result in dysuria after extubation ( 28 , 29 ). Two cases in this setting were observed in our study, but, after placement of an indwelling catheter for 1 week and infection control, the urination symptoms improved.…”

Section: Discussionmentioning

confidence: 99%

Immediate Transurethral Plasma Kinetic Enucleation of the Prostate Gland for Treatment of Benign Prostatic Hyperplasia-Associated Massive Hemorrhage: A Single-Center Experience

Gan

Deng

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

Purpose: Benign prostatic hyperplasia-associated massive hemorrhage is a urological emergency. We evaluated the outcome from immediate transurethral plasma kinetic enucleation of the prostate gland (i-TUPKEP) for BHM treatment.Methods: We retrospectively analyzed the records of 49 patients with acute BMH who underwent i-TUPKEP between January 2014 and November 2018 at our institution. The hemostatic effect, International Prostate Symptom Score (IPSS), and quality of life (QoL) score were evaluated preoperatively as well as 3, 6, and 12 months postoperatively. Postoperative follow-up also included measurement of the peak flow rate (Qmax) and post-void residual urine volume (PVR). Clinical characteristics, weight of resected tissue, duration of bladder irrigation, duration of hospital stay, complications, as well as the time required for enucleation and resection, were recorded.Results: BMH causes were attributed to transurethral surgery (17/49, 34.7%), violent catheterization (13/49, 26.5%), cystoscopy (10/49, 20.4%), and urethral dilatation (9/49, 18.4%). Bleeding was from different sites of prostate-gland tissues during i-TURKEP. i-TUPKEP-controlled BMH effectively induced immediate, notable, and lasting improvements in the IPSS and QoL score. Qmax was close to normal, and the PVR was within the physiological range, postoperatively. Long-term complications were not observed.Conclusion: Our preliminary data suggest that i-TUPKEP is a feasible method for controlling BHM and relieving BPH symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Immediate Transurethral Plasma Kinetic Enucleation of the Prostate Gland for Treatment of Benign Prostatic Hyperplasia-Associated Massive Hemorrhage: A Single-Center Experience

Gan

Deng

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…However, the possibility to use VB technology also with reusable bers and on medium power platforms might help in fostering the spreading of HoLEP in upcoming years. Indeed, the non-inferiority of low-power HoLEP with respect to high power HoLEP has been investigated [18,19]. For instance, Elshal et al compared 50W and 100W power HoLEP techniques, reaching comparable improvement in IPSS, Qmax, median reduction in PSA with similar perioperative and late postoperative complications [18].…”

Section: Discussionmentioning

confidence: 99%

Holmium Laser Enucleation of the Prostate With Virtual Basket Mode: Faster and Better Control on Bleeding

Bozzini

Maltagliati

Besana

et al. 2020

Preprint

View full text Add to dashboard Cite

BACKGROUND: To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate with Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH).METHODS: This prospective randomized study enrolled consecutive patients with BPH to HoLEP (n = 100) or VB-HoLEP (n =100). We evaluated all patients preoperatively with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We evaluated also the patients at 3, 6 and 12 months after surgery with the use of maximum flow rate (Qmax), postvoid residual urine volume (PVR) and International Prostate Symptom Score (IPSS).RESULTS: We didn’t see significant difference in preoperative parameters between patients in each study arm. Compared with HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs 1.12 g/dL, P = .003) and had a more rapid operative time (57.33±29.71 vs 42.99±18.51 minutes, P = 0.04). HoLEP and VB-HoLEP had same catheterization time (2.2 vs 1.9 days, P = 0.45), irrigation volume (33.3 vs 31.7 L, P = 0.69), and hospital stay (2.8 vs 2.7 days, P = 0.21). During the follow-up of subsequent 12 months, we didn’t demonstrate a significant difference in IPSS, Qmax, PVR, and QOLS.CONCLUSION: HoLEP and VB-HoLEP both are efficient a safe procedure for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and to allow a faster procedure. However, procedures did not differ significantly in catheterization time, hospital stay, operation time and irrigation volume. No differences were demonstrated in QOLF, IPSS, Qmax and PVR through the post-surgery 12 months of follow-up.TRIAL REGISTRATION: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

show abstract

“…With the emergence of advanced endoscopic techniques and the introduction of new medical concepts for BPE, minimally invasive endoscopic enucleation of the prostate, which can remove the prostate in a manner that is anatomically similar to open prostatectomy, has been an alternative surgical procedure for large prostate adenomas. Holmium lasers (Elshal et al, ), thulium lasers (Dellabella & Castellani, ) and greenlight lasers (Yoo et al, ) are usually adopted to enucleate the prostate because of the properties of high vaporisation and excellent coagulation, which are safe and effective techniques for large‐sized prostates. Increasing studies have reported that they can substitute OP.…”

Section: Discussionmentioning

confidence: 99%

Impact on sexual function of plasma button transurethral vapour enucleation versus plasmakinetic resection of the large prostate >90 ml: Results of a prospective, randomized trial

Wang

Zhang

et al. 2019

Andrologia

View full text Add to dashboard Cite

To compare the impact of plasma button transurethral vapour enucleation of the prostate (PVEP) and plasmakinetic resection of the prostate (PKRP) on lower urinary tract symptoms and sexual function in patients with benign prostatic enlargement (BPE) >90 ml. Between July 2017 and August 2018, 101 patients with symptomatic BPE were randomly, prospectively assigned to either PKRP or PVEP in our department. The clinical characteristics and sexual function were evaluated before and after surgery. Post‐void residual volume, IPSS and QoL were all significantly decreased compared with baseline data in each group, while Qmax was significantly increased. The IIEF‐5 score showed a slight but nonsignificant increase in both groups at 3 and 6 months after surgery, and there was no significant difference between the two groups. The post‐operative rate of reduced ejaculate volume was significantly higher than the pre‐operative rate in PKRP group, while there was no significant difference in PVEP group. PVEP had an attenuated effect on no ejaculate compared with PRKP, and they both had a significantly negative effect on no ejaculate. PVEP is an effective and minimally invasive procedure for large prostate. Compared with PKRP, PVEP has no effect on erectile dysfunction and has a lower negative impact on ejaculation.

show abstract

Low-Power Vs High-Power Holmium Laser Enucleation of the Prostate: Critical Assessment through Randomized Trial

Cited by 29 publications

References 28 publications

Immediate Transurethral Plasma Kinetic Enucleation of the Prostate Gland for Treatment of Benign Prostatic Hyperplasia-Associated Massive Hemorrhage: A Single-Center Experience

Immediate Transurethral Plasma Kinetic Enucleation of the Prostate Gland for Treatment of Benign Prostatic Hyperplasia-Associated Massive Hemorrhage: A Single-Center Experience

Holmium Laser Enucleation of the Prostate With Virtual Basket Mode: Faster and Better Control on Bleeding

Impact on sexual function of plasma button transurethral vapour enucleation versus plasmakinetic resection of the large prostate >90 ml: Results of a prospective, randomized trial

Contact Info

Product

Resources

About