Measuring change in prostate size after holmium laser enucleation: A prospective study

Oh, Jin Kyu; Ko, Kwang Pil; Oh, Seung June

doi:10.4111/icu.2017.58.3.200

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…HoLEP was carried out by a single surgeon (JSP), as described previously [ 8 , 9 ]. Briefly, we carried out enucleation that involved exposing the surgical capsule by incisions at the 5 and 7 o’clock positions just above the verumontanum, enucleating the median lobe, and then enucleating the lateral lobes.…”

Section: Methodsmentioning

confidence: 99%

Self-assessed goal achievement (SAGA) after Holmium laser enucleation of the prostate (HoLEP): Association with patients' postoperative satisfaction

Cho

Kim

et al. 2018

PLoS ONE

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This study aimed to determine serial changes in self-assessed goal achievement (SAGA) and treatment satisfaction after HoLEP, to identify correlations between the two, and to compare them with results assessed by traditional outcome measures. For a total of 170 patients, outcomes were evaluated serially at postoperative 1-, 3-, 6-, and 12-months using IPSS, OABSS, SAGA questionnaires and uroflowmetry. The SAGA questionnaire consisted of five questions including one open-ended question (self-assessed goals and degree of SAGA) and another question regarding treatment satisfaction. The number of self-assessed treatment goals was two or more in 74.1% of the patients. Most common treatment goal was relief from straining/hesitancy, followed by increased daytime frequency, nocturia and feeling of incomplete emptying. Degree of achievement for the first or second goal and treatment satisfaction tended to increase with time throughout the follow-up period. Patients with the greatest treatment satisfaction scores showed greater improvement by traditional outcome parameters including quality of life (QOL) index, total OABSS, maximum flow rate (Qmax), post-void residual urine volume (PVR) and bladder voiding efficiency (BVE) compared to those without treatment satisfaction. After adjusting for other influential variables, the improvements in subjective outcome parameters including total IPSS, QOL index and total OABSS were significantly associated with treatment satisfaction, but improvements in objective outcome parameters including Qmax, PVR and BVE were not. In addition, the degree of SAGA for the first goal or second goal was more predictive in determining treatment satisfaction than the traditional outcome measures. In conclusion, treatment goals of patients with lower urinary tract symptoms (LUTS)/BPH vary from individual to individual. The degree of SAGA and treatment satisfaction for HoLEP tends to increase with time throughout the follow-up period. Compared to the traditional outcome measures, the degree of goal achievement can be more predictive when assessing patient-centered outcomes such as treatment satisfaction.

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Section: Methodsmentioning

confidence: 99%

Self-assessed goal achievement (SAGA) after Holmium laser enucleation of the prostate (HoLEP): Association with patients' postoperative satisfaction

Cho

Kim

et al. 2018

PLoS ONE

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“…In Turkey, a research team reported a morcellated prostate volume of 29.2 ± 11 ml [11], while another team reported that the resected adenoma volume was 52.3 ± 8.3 ml [29]. In South Korea, a sonographically calculated resected prostate tissue volume of 29.2 ± 20.1 ml [30] was reported in keeping with our observation that prostates we see in Nigeria or Africa presenting for surgery are much bigger than those seen in several other continents.…”

Section: Discussionmentioning

confidence: 99%

Initial experience with holmium laser enucleation of the prostate in a urology specialist hospital in Nigeria

Undie¹,

Nnana²,

Torporo³

2021

Afr J Urol

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Background Holmium laser enucleation of the prostate (HoLEP) is a more recent procedure for the management of Benign Prostatic Hyperplasia compared to open prostatectomy or Transurethral Resection of the Prostate. HoLEP is not commonly done in Nigeria. The objective of the study was to determine whether our initial experience with HoLEP in Abuja, favourably compared to those of other centres across the world. Methods A retrospective study was done on 40 patients who had HoLEP between October 2018 and December 2019. Pre- and post-operative International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), prostate sizes, maximum flow rate (Qmax) and post-void residual urine volume (PVR) were collated. The duration of irrigation, catheterization and length of hospital stay were also recorded and analysed. Complications were documented. Results There were improvements in IPSS from 19.67 to 5.41, PSA from 8.07 to 2.03 ng/ml,Qmax from 11.27 to 29.67 ml/min, PVR from 88.99 to 32.8 ml, while average prostate sizes reduced from 116.54 to 30.3 g after surgery. Following HoLEP, the duration of irrigation was 18.00 h, catheterization was 26.76 h and length of hospital stay was 1.82 days. Two (5.0%) patients were recatheterized, 4 (10.0%) developed post-operative bladder neck stenosis. Conclusions The outcome of HoLEP in our experience compared favourably with those from other centres. With adequate training and requisite equipment in resource-poor environments, technical procedures like HoLEP can be embarked on with favourable results.

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“…A prospective study found calculated enucleated volume was 26% higher than the postoperative specimen weight. 17 Therefore, the very small weight of 0.5g is unlikely to reflect the true amount of specimen enucleated.…”

Section: Discussionmentioning

confidence: 99%

Holmium laser enucleation of the prostate: A single-centre case series of 1000 patients

Whiting

Penev

Guest

et al. 2021

Journal of Clinical Urology

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Objective: To describe the short and long-term complications of over 1000 cases of Holmium laser enucleation of the prostate (HoLEP) in a single centre. Methods: A prospective database of all HoLEP procedures performed between December 2003 and March 2017 was analysed. Results: A total of 1016 HoLEP procedures were performed. Median patient age was 72 years (range 41–95). There was a significant improvement in urinary flow, post-void residual volume, IPSS and QoL score ( p < 0.0001). Pre-operative acute urinary retention was present in 403 patients (39.7%). Post-operatively five patients (1.2%) continued with a long-term catheter. Early and late complications consisted of failed initial voiding trial (10.6%), stress incontinence (transient 6.5%; persistent 0.3%), frequency/dysuria (5.6%), urinary tract infection (5.3%), urethral stricture (4.8%), submeatal stenosis (1.9%), return to theatre (1.5%), bladder neck stenosis (1.3%), bleeding (1.2%), epididymitis (0.7%), confusion (0.3%), transurethral resection of the prostate conversion (0.2%), ureteric obstruction (0.2%), vomiting (0.2%), anuric renal failure (0.1%), chest infection (0.1%), chest pain (0.1%), myocardial infarction (0.1%), rectoprostatic fistula (0.1%), supraventricular tachycardia (0.1%) and urinary sepsis (0.1%). Five-year reoperation rate was 3.7%. Conclusion: HoLEP is a safe treatment for bladder outflow obstruction secondary to an enlarged prostate. It is associated with few early and late complications and has a low reoperation rate. Level of evidence: 4

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Measuring change in prostate size after holmium laser enucleation: A prospective study

Cited by 6 publications

References 12 publications

Self-assessed goal achievement (SAGA) after Holmium laser enucleation of the prostate (HoLEP): Association with patients' postoperative satisfaction

Self-assessed goal achievement (SAGA) after Holmium laser enucleation of the prostate (HoLEP): Association with patients' postoperative satisfaction

Initial experience with holmium laser enucleation of the prostate in a urology specialist hospital in Nigeria

Holmium laser enucleation of the prostate: A single-centre case series of 1000 patients

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