Monopolar Transurethral Enucleo-Resection of the Prostate Versus Holmium Laser Enucleation of the Prostate: A Canadian Novel Experience

Ajib, Khaled; Zgheib, Joseph; Salibi, Noura El; Zanaty, Marc; Mansour, Mila; Al‐Enizi, Abdullah M.; El-Hakim, Assaad

doi:10.1089/end.2017.0853

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…Khaled and his colleagues retrospectively analyzed the change of PSA in patients undergoing TURP and HoLEP, and found that the level of serum PSA dropped more in HoLEP group. [17] Nielsen et al found that PSA released after prostatectomy was associated with an increase in postoperative PF1+2 and TAT. [14] This may be due to the fact that the PSA is structurally and functionally very similar to the protein that activates the clotting reaction, since they all belong to the serine protease family, [18] although underlying mechanism is unclear.…”

Section: Discussionmentioning

confidence: 99%

Transurethral resection versus holmium laser enucleation of the prostate

Bai

Feng

et al. 2019

Medicine

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Objectives: The purpose of this study was to compare transurethral resection of the prostate (TURP) versus holmium laser enucleation of the prostate (HoLEP) in patients with benign prostatic hyperplasia (BPH) focusing on perioperative thrombin generation and fibrinolysis. Methods: Sixty-five BPH patients were prospectively randomly assigned to undergo TURP (n = 32) or HoLEP (n = 33). The prothrombin fragment (PF) 1+2, thrombin-antithrombin complex (TAT), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) were measured preoperatively, at the 1st day and 3rd day after surgery. Results: PF1+2, TAT, t-PA, and PAI-1 significantly elevated at day 1 and day 3 after surgery ( P < .05) and remarkedly decreased from the 1st day to the 3rd day ( P < .05). The levels of PF1+2 and TAT were higher in TURP group postoperatively than that in HoLEP group ( P < .05). There is no significant difference between 2 groups in regard of t-PA and PAI-1 ( P > .05). Conclusion: The activation of thrombin generation and fibrinolysis system were noticed in BPH patients after TURP or HoLEP. TURP may associate with a higher hypercoagulable thrombotic risk than HoLEP.

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Section: Discussionmentioning

confidence: 99%

Transurethral resection versus holmium laser enucleation of the prostate

Bai

Feng

et al. 2019

Medicine

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“…After removal of duplicates, 258 articles were reviewed based on title and abstract. Eighty-one articles underwent full-text review, and 57 studies were finally included [9‒65] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Perioperative Outcomes of Holmium Laser Enucleation of the Prostate: A Systematic Review

et al. 2021

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Introduction: The aim of the study was to systematically review the literature and describe perioperative complications of holmium laser enucleation of the prostate (HoLEP), including the Clavien-Dindo classification of surgical complications. Methods: All English language publications on HoLEP were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines to evaluate PubMed®, Scopus®, and Web of Science™ databases from January 1, 1998, to June 1, 2020. Results: Fifty-seven studies were included, for a total of 10,371 procedures. We distinguished between intra-, peri-, and postoperative complications. Overall, the rate of complications is 0–7%. Intraoperative complications include incomplete morcellation (2.3%), capsular perforation (2.2%), bladder (2.4%), and ureteric orifice (0.4%) injuries. Perioperative complications include postoperative urinary retention (0.2%), hematuria and clot retention (2.6%), and cystoscopy for clot evacuation (0.7%). Postoperative complications include dysuria (7.5%), stress (4.0%), urge (1.8%), transient (7%) and permanent (1.3%) urinary incontinence, urethral stricture (2%) and bladder neck contracture (1%). Conclusions: HoLEP is a safe procedure, with a satisfactory low complication rate. The most common reported perioperative complications are not severe (Clavien-Dindo classification grades 1–2). Further randomized studies are certainly warranted to fully determine the predictor of surgical complications in order to prevent them and improve this technique.

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“…The complications and short-term results in terms of IPSS, Qmax and PVR were similar. They reported complications like TUR syndrome and excessive bleeding with larger prostates, which were not issues in the studies of Ajib [ 20 ] and Pansadoro [ 18 ]. They found that the learning curve of monopolar enucleation was slightly higher than HOLEP but concluded that monopolar enucleation is a relatively safer procedure as no serious complications were encountered during the early learning curve.…”

Section: Discussionmentioning

confidence: 99%

“…Ajib [ 20 ] described the TUERP technique in comparison with HOLEP in 2019 (24 vs. 27 cases); they resected the median lobe in a similar manner to TURP and then enucleated the lateral lobes. If the lobes were completely enucleated, they was morcellated or else resected with a loop.…”

Section: Discussionmentioning

confidence: 99%

Monopolar Transurethral Enucleoresection of Prostate: Feasibility of Modified Nesbit’s Enucleoresection with Apical Release

Kumar,

Somani

2024

JCM

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Background: Transurethral resection of the prostate (TURP) has been the standard surgical treatment for Benign Hyperplasia of the Prostate (BPH) for decades. Our objective was to evaluate the outcome of our new technique: Monopolar Transurethral Enucleoresection of the Prostate (TUERP) with apical release (bring it all to centre). Methods: A prospective study of all cases undergoing TUERP at a tertiary centre from January 2020 to October 2022 was performed. Patient demographics, intraoperative variables and postoperative results along with follow-up data were collected. Data of all the cases who had completed a one-year follow-up post-surgery were included and analysed. Results: A total of 240 patients with complete data including a one-year follow-up were included. Mean prostatic volume was 55.3 ± 11.6 gm, and 28 (11.67%) cases were >100 gm. The mean operative time was 31.7 ± 7.6, and mean haemoglobin drop at 24 h was 0.73 ± 1.21 gm/dL. The overall complication rate was 16.67%, with only two (0.83%) Clavien–Dindo III complications (haematuria and clots needing evacuation) and the other complications being Clavien–Dindo I/II complications. Sustained improvement at 1 year of follow-up was noted: Qmax: 25.2 ± 5.6 mL/s, IPSS: 4.7 ± 2.5 and PVR: 22.5 ± 9.6 mL. Conclusions: Monopolar TUERP with a modified Nesbit’s enucleoresection with apical release can be considered a promising technique, which needs further studies to be validated with appropriate comparisons.

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Monopolar Transurethral Enucleo-Resection of the Prostate Versus Holmium Laser Enucleation of the Prostate: A Canadian Novel Experience

Abstract: In this study, TUERP was safe and efficacious in benign prostatic hyperplasia patients with large glands. Modifications can be implemented on the standard transurethral resection of the prostate technique to treat patients with prostate sizes >70 cc.

Cited by 7 publications

References 27 publications

Transurethral resection versus holmium laser enucleation of the prostate

Transurethral resection versus holmium laser enucleation of the prostate

Perioperative Outcomes of Holmium Laser Enucleation of the Prostate: A Systematic Review

Monopolar Transurethral Enucleoresection of Prostate: Feasibility of Modified Nesbit’s Enucleoresection with Apical Release

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